Biliary Variant in a Potential Liver Donor

A55 year-oldmanwith no known medical conditions or surgical history presented to our hospital to be evaluated as potential living liver donor. In our centre donor candidates are evaluated using a specific living donor protocol; this includes imaging studies for liver volumetrics (to quantify the amount of parenchyma that could be donated versus the remnant) and liver vascular anatomy, and magnetic resonance cholangiopancreatography (MRCP) to evaluate anatomy of the biliary tree. Computed tomography scanning was performed to estimate volume of the right and left lobes of the liver: the right lobe would be harvested for transplantation into the recipient, while the left would be the donor’s remnant liver; the test confirmed adequate volume of both liver lobes. MRCP showed biliary variants characterized by a right posterior hepatic duct (RPHD), which in classic biliary anatomy fuses with the right anterior duct to constitute a short right hepatic duct, draining directly into the common hepatic duct (CHD) (Fig. 1A, arrow). MRCP also showed that the cystic duct, which usually drains into the lateral aspect of the CHD below its origin, drained directly into theRPHDabove its confluence with theCHD(Fig. 1B, arrow). Classic biliary anatomy appears in about 58% of the population, while the variant in which RPHD drains directly into the CHD has a prevalence of approximately 5% [1]. These anatomical biliary variants are relevant in potential donors evaluated for living donor liver transplantation.