Variation in the venous drainage of left lateral segment liver graft requiring reconstruction of segment III vein with donor iliac artery

In summary, the knowledge of hepatic vein drainage is essential for transplant surgeons involved in split and living donor liver transplantation. The type 3 variant is not a contraindication to split or living donor liver transplantation, as venous reconstruction is possible with good functional results. The iliac artery provides a good conduit for venous reconstruction ensuring patency, avoiding congestion and increased blood loss during the procedure, with good graft function in the early postoperative period. We believe that even if it gets thrombosed in a few weeks, long-term patency is not essential, as good collateral circulation would have developed or atrophy of segment III with hypertrophy of segment II would compensate for necessary liver volumes. © 2008 AASLD.