Right lobe living donor liver transplantation in a donor with middle hepatic vein ostial stenosis: a rare case report.

The advancements in living donor liver transplantation surgeries bring hope to many patients with end-stage chronic liver disease in scenario of limited deceased organ availability. In the desperate situation of worsening condition of liver recipient and nonavailability of deceased organ, the surgeon may need to take a difficult decision to accept a living donor with technically challenging anatomy. Here, we present the first reported case of a successful living donor liver transplantation from an otherwise healthy donor, who incidentally had middle hepatic vein ostial stenosis with venovenous collateralization. Both the donor and recipient had an uneventful posttransplant recovery and normal follow-up imaging. The case demonstrates overcoming the limitation of difficult venous anatomy with adequate surgical precision.