Imaging-based analysis of right inferior accessory hepatic vein variations in living donors: relevance to operative decision-making and graft outcomes.
Larger accessory hepatic veins strongly linked to middle hepatic vein dominance over right vein.
Imaging-based analysis of right inferior accessory hepatic vein variations in living donors: relevance to operative decision-making and graft outcomes.
Variations in the anatomy of the right inferior accessory hepatic vein (IRHV), particularly in their presence and size are known to influence hepatic venous dominance and the need for middle hepatic vein (middle hepatic vein) reconstruction.
This study aims to analyse IRHV variations using multidetector computer tomography (multidetector computer tomography) in live liver donors and assess their impact on hepatic venous dominance and the need for middle hepatic vein reconstruction to mitigate posttransplant complications.
A prospective analysis of 200 live liver donors was conducted using multidetector computer tomography to assess liver volumetry, IRHV variations, and hepatic venous dominance.
IRHV was present in 41% of cases with 21.5% classified as type II (<4 mm) and 19.5% as type III (>4 mm).
A statistically significant inverse correlation was observed between right hepatic vein (right hepatic vein) and IRHV diameters (Pearson's coefficient = -0.382, P<.05).
Although graft survival rates were lower in type III IRHV cases (69.2%) compared to type I (83.9%), this difference was not statistically significant (P=.106).
IRHV variations significantly affect hepatic venous dominance, particularly in type III IRHV cases, which require middle hepatic vein reconstruction to ensure adequate venous drainage and prevent graft congestion.
Accurate identification of variations in donors is a critical step in surgical planning and minimising posttransplant complications.