Ultrasonographic anatomy of veins draining the left lobe of the liver. Feasibility of live related transplantation.

The anatomic variations of the left hepatic vein (LHV) in 182 patients with normal liver functions were analyzed using ultrasonography in order to clarify the feasibility of live related hepatic transplantation (LRHT). LHV was demonstrated in 151 patients (83%). Based on the location of the confluence of the middle hepatic vein (MHV) and LHV and the ramifications of the left medial vein (LMV) and the left superior vein (LSV), the livers were classified into 3 types: a) intrahepatic confluence (42/151 livers, 27.8%); b) extrahepatic confluence (69/151 livers, 45.7%); c) separate insertion (40/151 livers, 26.5%); and 23 subtypes. The length of the common trunk and the intrahepatic common trunk of MHV and LHV and the distance from LMV or LSV to the confluence of MHV and LHV were measured. Overall, the control of LHV in situ for LRHT appeared easy in 34/151 patients (22.5%), while in 44/151 patients (29.1%), the length of free LHV and the common trunk was less than optimal for procurement of a left hepatic lobe graft with complete venous outflow and sufficient extraparenchymal length of LHV.