Efferent blood supply to the right hepatic lobe regarding its transplantation from a living donor: variant anatomy, classification. Part 1

Aim. To describe new data and to complement the existing information about the anatomic features of the hepatic vein structure in the donor of the right hepatic lobe, to formulate the principles of donor selection proceeding from vascular anatomy.Materials and methods. 306 liver transplantations from living related donors were performed at A.I. Burnazyan Federal Medical Biophysical Center of Federal Medical and Biological Agency of Russia from 2009 to 2021. The vascular anatomy of 518 potential donors was analyzed. The prevalence of different vein structures of the right hepatic lobe was assessed.Results. The authors identified 14 subtypes of anatomy of efferent vessels. They were classified into 3 types depending on the contribution of the median vein to the blood outflow from the right hepatic lobe: caval (67.3%), cava medial (semi-separate, 29%), and separate (3.6%).Conclusion. The anatomy of the efferent vessels of the right lobe graft is characterized by variability and complexity. It requires accurate assessment at the preoperative stage (CT scanning) to be ready for reconstruction of any complexity.