THE SIGNIFICANCE OF ARTERIAL VASCULAR SUP PLY OF SEGMENT-IV IN LIVER TRANSPLANTATIONS FROM LIVING DONORS

The significance of arterial vascular supply of segment IV in liver tr ansplantations from living donors. Purpose: Postoperative CT's in livi ng liver donors were analysed retrospectively to examine whether atrop hies of segment IV occur after procurement depending on arterial vascu lar supply. Patients and methods: Postoperative CT's from 19 living do nors were retrospectively analysed. DSA of the upper abdomen had been performed on all donors prior to donation. Results: The preoperative D SA images demonstrated an arterial vascular supply of segment IV from the right hepatic artery in 10/19 cases, from the left hepatic artery in 7/19 cases and from both, left and right hepatic artery, in 2/19 ca ses. Atrophies were seen in 3/7 patients in which segment IV was perfu sed via left hepatic artery, in further two patients with perfusion fr om the right hepatic artery or from both sides respectively Clinically only one patient presented with an abscess. Conclusions: The patterns of vascular supply to segment IV seen in our patients differ from tho se published by Couinaud. Since only 3/7 patients with an arterial sup ply from the left hepatic artery developed a segmental atrophy, we con clude that there must be additional, radiologically not identifiable p ortal venous branches or collaterals from the right portal vein that m aintain perfusion of segment IV.