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| Absent middle hepatic vein in a right liver graft donor |
| Sheung Tat Fan and Yik Wong |
Hong Kong, China
Author Affiliations: Department of Surgery (Fan ST), and Department of Diagnostic Radiology (Wong Y), The University of Hong Kong, Pokfulam, Hong Kong SAR, China
Corresponding Author: Professor Sheung Tat Fan, Chair Professor of Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China (Tel: 852- 2855 4703; Fax: 852-2818 4407; Email: stfan@hku.hk) |
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Abstract BACKGROUND: The middle hepatic vein (MHV) is normally in form of a large trunk lying within the midplane of the liver. An anomaly in form of two separate trunks, each draining segment Ⅴ/Ⅷ and segment Ⅳ, has been described by Couinaud but not been well documented in the literature.
METHOD: We report a right liver donor in whom the MHV was absent and not encountered during liver transection along the midplane of the liver.
RESULTS: On computed tomography (CT) scan and intraoperative ultrasonography, there was a large segment Ⅷ hepatic vein mistaken as the MHV on preoperative assessment and a large segment Ⅳ hepatic vein close to the ligamentum venosum. CT volumetry based on either segment Ⅷ or Ⅳ hepatic vein led to major error in liver volume calculation. Transection of the liver guided by segment Ⅷ or Ⅳ hepatic vein would lead to sacrifice of liver parenchyma unnecessarily or presence of necrotic liver in the graft.
CONCLUSION: Absent MHV is a rare anomaly. It is revealed by careful study of the CT scan.
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2008, Vol. 7 
