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Abstract
Despite advances in medical therapy, liver replacement
continues to be the only definitive mode of therapy for people with end stage liver disease.
The increased population of patients with end stage liver disease and the religious and cultural objections to deceased donor transplantation have created the driving force for adult-to-adult LDLT in Egypt.
The surgery of living donor liver transplantation is more technically challenging than cadaveric whole liver transplantation . It requires a thorough understanding of the intra- and extra-hepatic anatomical relationships between the portal vein, hepatic artery, biliary tract, and hepatic vein.
Portal vein reconstruction is a crucial factor affecting the outcome of a successful living-related liver transplantation and hence the preoperative evaluation of the vascular anatomy of the donor is of the utmost importance to identify the anatomic variants in potential donors and the means of coping with them.
The anatomy of the portal vein is usually classified as 5 patterns with over 80 % representing the normal bifurcated type in most review series . The anatomic variants of the portal vein can almost always be dealt with successfully ensuring a sound and safe anastomosis and as a result adequate portal flow to the graft.
Our study comprised the study of the portal vein anatomy in 31 potential donors for LDLT ; 24 showed the normal bifurcated pattern of the portal vein whereas only 7 showed anatomic variants.
7 of these potential donors have passed the multi step preoperative evaluation stage and a donor hepatectomy was performed to this group.