Living related liver transplantation from donors with the left-sided gallbladder/portal vein anomaly

The presence of a left-sided gallbladder poses a unique challenge for Livin g related liver donation. Associated anomalies include segment IV atrophy, absence of portal vein bifurcation, and abnormal intrahepatic portal branch es to segments II and III. The complex is rare, but is more frequent in Jap an. Of 379 living related liver transplants from our institution, the compl ex has been encountered on four occasions (incidence: 1.1%), and we herein review our experience. Anomalies were identified preoperatively (by compute d tomography and ultrasound) in all instances. One donor was turned down be cause there was no common portal trunk to segment II and III branches. Thre e donors underwent successful retrieval using a modified technique. There w ere no complications in the donors or recipients relating to the complex. T hus, living related liver retrieval can be achieved safely in the presence of the left-sided gallbladder/portal anomaly complex, but technical modific ations are required.