Skip to main content
SpringerLink
Log in

Two novel hepatic arterial variations in a living liver donor detected by multidetector computed tomography angiography

  • Anatomic Variations
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

Considering that the knowledge of variations in the hepatic vascular structure is essential for hepatic surgery and liver transplantation, we aimed to present a rare case of the anatomic variation of arterial blood supply to the liver to help prevent complications and choose suitable donors.

Methods

We present a novel variant in this case report (living liver donor), an accessory right hepatic artery (supplying segment 6) originating from the dorsal pancreatic artery and a middle hepatic artery (supplying segment 4) arising from the pancreaticoduodenal artery (first branch of the gastroduodenal artery). Preoperative diagnosis was made using computed tomography angiography (CTA) with multiplanar reformate (MPR) images, curved planar reformate (CPR), maximum intensity projection (MIP) images and three-dimensional volume renderings (3D VR).

Results

To the best of our knowledge, this is the first case in the English literature describing this type of variation. A search for new donors began since the living liver donor was not suitable due to the very thin segment 4 artery, posing potential risks for the donor and the thin segment 6 artery being a complicating factor for anastomosis.

Conclusions

The preoperative knowledge of liver blood supply has great importance in planning surgery and transplantation. CTA, reformate and reconstruction techniques allow for the evaluation of difficult and complex anatomic variations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

3D VR:

Three-dimensional volume renderings

CeT:

Celiac trunkus

CHA:

Common hepatic artery

CPR:

Curved planar reformate

CTA:

Computed tomography angiography

GDA:

Gastroduodenal artery

LGA:

Left gastric artery

LHA:

Left hepatic artery

MDCTA:

Multidetector computed tomography angiography

MHA:

Middle hepatic artery

MIP:

Maximum ıntensity projection

MPR:

Multi planar reformate

PHA:

Proper hepatic artery

RHA:

Right hepatic artery

SA:

Splenic artery

TACE:

Transcatheter hepatic arterial chemoembolization

References

  1. Al Zahrani Y, AlMat’hami A, Alobaidi H et al (2016) Accessory right hepatic artery arising from splenic artery supplying hepatocellular carcinoma identified by computed tomography scan and conventional angiography: a rare anatomic variant. Ann Vasc Surg 38:316.e1-316.e5. https://doi.org/10.1016/j.avsg.2016.05.096

    Article  Google Scholar 

  2. Anwar AS, Srikala J, Papalkar AS et al (2020) Study of anatomical variations of hepatic vasculature using multidetector computed tomography angiography. Surg Radiol Anat. https://doi.org/10.1007/s00276-020-02532-5

    Article  PubMed  Google Scholar 

  3. De Blasi V, Makkai-Popa ST, Arru L et al (2019) Rare anatomic variation of the hepatic arterial blood supply: case report and literature review. Surg Radiol Anat 41:343–345. https://doi.org/10.1007/s00276-018-2163-5

    Article  PubMed  Google Scholar 

  4. Ferrari R, De Cecco CN, Jafrate F et al (2007) Anatomical variations of the coeliac trunk and the mesenteric arteries evaluated with 64-row CT angiography. Radiol Med 112:988–998. https://doi.org/10.1007/s11547-007-0200-2

    Article  CAS  PubMed  Google Scholar 

  5. Kobayashi S, Otsubo T, Koizumi S et al (2014) Anatomic variations of hepatic artery and new clinical classification based on abdominal angiographic images of 1200 cases. Hepatogastroenterology 61:2345–2348

    PubMed  Google Scholar 

  6. Liang Y, Li E, Min J et al (2017) Rare anatomic variation of the right hepatic artery and accessory right hepatic artery supplying hepatocellular carcinoma: a case report and literature review. Medicine 96:e8144. https://doi.org/10.1097/MD.0000000000008144

    Article  PubMed  PubMed Central  Google Scholar 

  7. Michels NA (1966) Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg 112:337–347

    Article  CAS  Google Scholar 

  8. Nazer R, Nasir Khan AK, Ahmed A et al (2019) Segment IV hepatic artery in potential donors for living related liver transplantation: evaluation with multi-detector CT. J Pak Med Assoc 69:799–805

    PubMed  Google Scholar 

  9. Saba L, Mallarini G (2011) Anatomic variations of arterial liver vascularization: an analysis by using MDCTA. Surg Radiol Anat 33:559–568. https://doi.org/10.1007/s00276-011-0778-x

    Article  PubMed  Google Scholar 

  10. Stemmler BJ, Paulson EK, Thornton FJ et al (2004) Dual-phase 3D MDCT angiography for evaluation of the liver before hepatic resection. AJR Am J Roentgenol 183:1551–1557. https://doi.org/10.2214/ajr.183.6.0183155

    Article  PubMed  Google Scholar 

  11. Sureka B, Mittal MK, Mittal A et al (2013) Variations of celiac axis, common hepatic artery and its branches in 600 patients. Indian J Radiol Imaging 23:223–233. https://doi.org/10.4103/0971-3026.120273

    Article  PubMed  PubMed Central  Google Scholar 

  12. Thangarajah A, Parthasarathy R (2016) Celiac axis, common hepatic and hepatic artery variants as evidenced on MDCT angiography in south indian population. J Clin Diagn Res 10:TC01–TC05. https://doi.org/10.7860/JCDR/2016/17045.7105

    Article  PubMed  PubMed Central  Google Scholar 

  13. Ugurel MS, Battal B, Bozlar U et al (2010) Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography. Br J Radiol 83:661–667. https://doi.org/10.1259/bjr/21236482

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Walker TG (2009) Mesenteric vasculature and collateral pathways. Semin Intervent Radiol 26:167–174. https://doi.org/10.1055/s-0029-1225663

    Article  PubMed  PubMed Central  Google Scholar 

  15. Wang S, He X, Li Z et al (2010) Characterization of the middle hepatic artery and its relevance to living donor liver transplantation. Liver Transpl 16:736–741. https://doi.org/10.1002/lt.22082

    Article  PubMed  Google Scholar 

  16. Xie YZ, Liu J, Chung GH et al (2014) Visualization of the segment IV hepatic artery using 128-section MDCT angiography. Clin Radiol 69:965–973. https://doi.org/10.1016/j.crad.2014.05.001

    Article  CAS  PubMed  Google Scholar 

  17. Zaki SM, Abdelmaksoud AHK, Khaled BEA et al (2020) Anatomical variations of hepatic artery using the multidetector computed tomography angiography. Folia Morphol 79:247–254. https://doi.org/10.5603/FM.a2019.0090

    Article  CAS  Google Scholar 

Download references

Funding

No funds, grants, or other support was received.

Author information

Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Eskişehir Osmangazi University, Meşelik Yerleşkesi, 26480, Eskisehir, Turkey

    Elif Gündoğdu & Mahmut Kebapçı

Authors
  1. Elif Gündoğdu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mahmut Kebapçı
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

EG: manuscript drafting and submission, picture editing. MK: critical revision of the manuscript.

Corresponding author

Correspondence to Elif Gündoğdu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Written and informed consent for publishing this case report was obtained from the patient.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gündoğdu, E., Kebapçı, M. Two novel hepatic arterial variations in a living liver donor detected by multidetector computed tomography angiography. Surg Radiol Anat 43, 1385–1389 (2021). https://doi.org/10.1007/s00276-021-02730-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-021-02730-9

Keywords

Search

Navigation