Right anterior section graft for living donor liver transplantation

Summary In living-donor liver transplantation, the right lobe graft is commonly utilized to prevent small-for-size syndrome, despite the considerable donor morbidity. Conversely, the feasibility of the left lobe graft and the right posterior sector graft in smaller-sized recipients is now commonly employed with comparable outcomes to right lobe grafts. The efficacy of the right anterior sector graft has rarely been reported. Here, we describe a 56-year-old man, with alcoholic liver cirrhosis, who successfully underwent living-donor liver transplantation using the right anterior sector graft. Preoperatively, the right lobe of the donor occupied 76.2% of the total liver volume exposing the donor to a small residual liver volume. The right posterior sector and left lobe volumes were insufficient, providing a graft-to-recipient weight ratio of 0.42% and 0.38%, respectively. However, the right anterior sector could fulfill an acceptable GRWR of 0.83%. Clinical signs and symptoms and liver function improved following anterior section graft transplantation without complications. The procurement of anterior sector graft is technically feasible in selected patients, especially in high-volume liver centers.