Background: The portal vein variations are usually asymptomatic and mostly identified incidentally during surgeries and diagnostic angiographies. They are easy to recognize with 3D reconstruction of Computed Tomography. It has significant impact on living-donor liver transplantation.
Aim: To determine the spectrum and incidence of the anatomic variations in Intra Hepatic Main and Right Portal vein anatomy detected on Multi-detector CT Hepatic angiography of living liver donor of western Indian population and to discuss its surgical and radiological implications.
Material and Method: A retrospective review of multi-detector CT hepatic angiography was performed in patients sent for liver donor evaluation in our radiology department. Over a 6 year period, 132 donors were eligible for CT Hepatic angiography for possible living-donor liver transplantation (LDLT). The variations in branching pattern of main portal vein and segmental variation of right portal vein were classified according to Nakumura classification and classification proposed by Couinaud respectively.
Results: Normal (Type A) anatomy was seen in 108 donors. (81.8%). Trifurcation (Type B) variation was seen in 14 cases (10.6%). Right posterior vein as ﬁrst branch of MPV (Type C) variation was seen in 10 cases (7.57%). Type D variation and Type E variation were not seen our study. Eighty three (76.85%) of 108 donors with conventional MPV branching (type A) also had conventional RPV branching whereas 25 (23.1%) of these donors had variant RPV branching.
Conclusion: Variant portal vein anatomy is commoner than previously reported. Although anomalous anatomy is not always a contradiction for liver donation, its knowledge is critical in ensuring the safety of the donors and aids in selection of suitable candidates.