BACKGROUND: In right liver living donor liver trans-plantation, hepatic venous anastomosis is performed using the recipients right hepatic vein orifice. There may be situations that the portal vein is short or the right liver graft is small, leading to difficulty in portal vein, hepatic artery or duct-to-duct anastomosis.
METHODS: The recipients right hepatic vein orifice is closed partially for 2 cm at the cranial end or totally, and a new venotomy is made caudal to the right hepatic vein orifice. Hepatic vein anastomosis is performed with the new venotomy.
RESULTS: The distance between the liver graft hilum and hepatoduodenal ligament is reduced. Portal vein, hepatic artery and biliary anastomosis could be performed without tension or conduit.
CONCLUSION: Caudal shifting of hepatic vein anasto-mosis facilitates implantation of a right liver living donor graft.