Anomalous portal vein structure is a challenge to perform right splitting donor hepatectomy. Especially in LDLT (living donor liver transplantation), Identification of portal vein anomaly is very important to ensure donor safety and graft function. When we face double portal vein at right graft liver, we prefer autologous portal Y-graft (PYG) interposition to other methods.
Herein we report our case of Nakmura’s type D portal vein donor. Type D is more uncommon than other type and has more complicated out flow and bile duct problems. Which demand more skillful technique during donor hepatectomy.To solve these problems, we planned right extended hepatectomy and reconstructed portal flow with PYG interposition and out flow with one orifice collar patch graft in extended right liver graft. Both recipient and donor had uneventful course and discharged with good liver function.
Although, our experience was also little in anomalous graft as a small volume center, there were some interesting points in this case. We chose simple and intuitive procedure for type D right graft. We thought our method had some advantages in a special case.