What question did this study set out to answer?

This study aims to identify anatomical predictors of portal vein complications in living donor liver transplantation using dual portal vein grafts.

June 13, 2026Open Access

Anatomical risk stratification for major portal vein complications in dual portal vein living donor liver transplantation: a retrospective cohort study

Key Points

This study aims to identify anatomical predictors of portal vein complications in living donor liver transplantation using dual portal vein grafts.
Retrospective cohort study of living donor liver transplantation cases with dual portal vein grafts
Analysis of anatomical variations and donor-recipient characteristics
Assessment of complications like anastomotic stenosis and thrombosis
Anatomical geometry significantly predicts the risk of portal vein complications
Identified specific anatomical factors associated with higher complication rates
Surgical technique alone was insufficient to explain the variability in outcomes

Abstract

Living donor liver transplantation (LDLT) has become essential to address the persistent shortage of deceased donor organs 1-3.Among its technical challenges, right lobe grafts with dual portal vein (PV) orifices represent one of the most demanding anatomical variations 4-6.Reconstruction of dual PVs typically requires direct venoplasty, Y-graft interposition, or patch grafting, all of which are technically feasible and have shown comparable survival outcomes 6-10.However, our previous comparative analysis and other reports suggest that the choice of reconstruction technique alone does not account for the development of PV complications.Instead, anatomical geometry and donor-recipient characteristics may play a more decisive role, influencing the risks of anastomotic stenosis, thrombosis, and long-term graft dysfunction 6,8,11,12.This study, therefore, aimed to determine the independent predictors of PV complications in LDLT using dual PV grafts, focusing on the impact of anatomical factors rather than surgical technique.By clarifying these risk factors, we sought

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