Anatomical Variations in Living Donors for Liver Transplantation – Prevalence and Correlation

Abstract

Abstract Purpose: Living donor liver transplantation (LDLT) is a widely accepted option to address the lack of a deceased liver program for transplantation. Understanding vascular and biliary anatomy and their variants is crucial for successful and safe graft harvesting. Anatomic variations are common, particularly in the right hepatic lobe. To provide evidence for screening potential liver transplant donors, the presence of vascular and biliary anatomic variations in the preoperative assessment of transplantation donor candidates in Pakistan were explored. Methods: The was a retrospective cross-sectional study to evaluate the hepatic artery, portal vein, hepatic vein, and biliary variations in living liver donors. The study included 400 living liver donors, and data was collected from March 2019 to March 2023. We used a CT scan and MRCP to assess the anatomical variations. Results: The study examined 400 liver donors aged 18 to 53 years. Conventional arterial anatomy was the most common (65.8%), followed by replaced right hepatic artery (16%) and replaced left hepatic artery (10.8%). Conventional type 1 biliary anatomy was seen in 65.8% of cases. The dominant right hepatic vein was found in 13.3% donors. There was a significant association between the prevalence of variant portal venous anatomy with variant biliary anatomy. Conclusion: There was high variability in hepatic venous anatomy and a similar prevalence of variant hepatic arterial anatomy to other studies. A strong relationship between variant portal venous and biliary anatomy was found. These findings can aid in selecting suitable candidates and improving surgical planning for liver transplantation.