Hepatic flow optimization in full right split liver transplantation

Figure 1 A 44-year-old woman with hepatocellular carcinoma on alcoholic cirrhosis underwent liver transplantation receiving an in-situ full-right graft. A: A wide venous patch was created connecting V5, V8 and the right hemi-vena cava, using an interposing venous iliac patch from the same donor, preserving the small accessory veins and a right inferior hepatic vein; B: The graft is shown after reperfusion with the V5 and V8 draining into the vena cava. The portal vein anastomosis was performed between the right portal branch of the recipient and the right portal branch of the graft, with the left portal branch clamped for a possible hemiporto-caval shunt.