Objective:

To analyze early and long-term outcomes of inferior right hepatic vein (IRHV) reconstruction in right lobe living donor liver transplantation (RL-LDLT) and identify associated risk factors.

Approach:

• Study Design: Retrospective cohort study of RL-LDLT recipients who underwent IRHV reconstruction from January 2021 to December 2023.
• Patient Selection: Included patients who underwent IRHV reconstruction; excluded those with incomplete data, perioperative mortality, or anatomical variations preventing reconstruction.
• Data Collection: Data collected from electronic medical records, surgical reports, and imaging studies, categorized into preoperative, intraoperative, and postoperative variables.
• Surgical Techniques: Reconstruction classified as direct anastomosis, simple venoplasty, or complex venoplasty based on the surgical approach.
• Postoperative Evaluation: IRHV patency assessed via multidetector computed tomography (MDCT) within the first 30 days and during long-term follow-ups.
• Statistical Analysis: Used IBM SPSS Statistics for analysis, including ROC curve analysis and logistic regression to identify predictors of IRHV occlusion.

Key Findings:

• The study included 240 RL-LDLT cases with different IRHV reconstruction techniques.
• IRHV occlusion was linked to specific preoperative anatomical and clinical factors.
• The optimal IRHV diameter threshold for occlusion risk was identified through ROC curve analysis.

Interpretation:

Identifying high-risk patients based on anatomical and clinical factors can facilitate personalized surgical planning to improve transplant outcomes.

Limitations:

• The retrospective design may introduce selection bias.
• Findings from a single-center study may not be generalizable.

Conclusion:

The study provides insights into risk factors for IRHV occlusion.