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Left liver plus CL graft is a useful option for adult living-related donor liver transplantation (LDLT), because the addition of the CL can provide an 8�C12% increase in graft weight [2]. Serious problems can affect grafts, especially in the initial few weeks after small-for-size liver-graft transplantation. Blood-vessel deformation and stenosis caused by rapid graft regeneration can be lethal [3]. One of the major challenges in LDLT is small vessels reconstruction in small-for-size liver grafts. Various reconstruction techniques have been devised to minimize vessel deformation and increase blood flow to the CL, to ensure full functioning of the graft. These techniques might increase the margin of safety for small-for-size liver-graft transplantation. In this article, we summarized the advances made in the techniques and impact of CL venous reconstruction in left liver graft for increasing additional safety http://www.selleckchem.com/products/z-vad-fmk.html margin in living-donor-related liver transplantation. Classical end-to-side direct anastomosis of a liver graft to the inferior vena cava (IVC) can cause twisting and deformation at the anastomotic site because of graft regeneration. This is significant in the first few weeks after surgery, when the caval window of the IVC is thin and the distance from the IVC is short [3]. End-to-end anastomosis has been widely used to overcome this problem. A large orifice with two (left and middle hepatic veins) or three (left, middle, and right hepatic http://www.selleck.cn/products/BIBW2992.html veins) major hepatic veins is commonly created at the recipient site [2]. Various reconstruction techniques (simple venoplasty, septoplasty, rectangular plasty, venoplasty with a vein graft patch, and creation of a wide circular cuff by vein grafting) are used depending on the grafted vessels [4�C7]. In recent cases with a marginal http://www.selleckchem.com/products/ly2157299.html predicted graft size relative to the recipient��s metabolic demand, the short hepatic vein (SHV) was aggressively reconstructed [3,8]. Venous drainage from the CL occurred through the SHV and intraparenchymal communication. Good blood flow from other segments to the CL parenchyma might have facilitated graft growth. Without SHV reconstruction, the CL was often atrophied or regenerated slowly [9]. As reported in a previous study, the regeneration rates of the CL and other segments 1?month after LDLT without SHV reconstruction were 62?��?24% and 152?��?35%, respectively [10]. This was potentially attributable to insufficient venous drainage from the CL. By contrast, the regeneration rate of the CL with SHV reconstruction was greater than or equal to those of other segments. When the SHV was