A side-to-side cavocavostomy using partial clamping of the recipient inferior vena cava is performed (see also chapter "Orthotopic Liver Transplantation"). Resection of the retrocaval and left part of Sgl during back-table procedure improves exposure and thereby easy anastomosis between the two caval veins. The same technique can be applied for the left graft in a procedure for two adult recipients, as in this situation the cava remains with the left liver.
An end-to-end portal vein anastomosis is performed between the right branch of the portal vein of the graft and the common trunk of portal vein of the recipient. If long enough, the right hepatic artery is anastomosed to the hepatic artery of the recipient at the level of the bifurcation with the gastroduodenal artery. Otherwise it is anastomosed to the right or common hepatic artery. Finally, the right hepatic duct is connected to the common bile duct of the recipient applying the same technique as in orthotopic liver transplantation.
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