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BACKGROUND:?Controversy?remains?over?whether?the?middle?hepatic?vein?should?be?included?in?the?liver?graft?in?right?liver?living?donor?liver?transplantation.?Congestion?in?the?anterior?sector?of?a?right?liver?graft?can?cause?graft?malfunction,?which?is?especially?devastating?in?the?case?of?a?graft?with?marginal?size?in?relation?to?recipient?body?size?on?top?of?poor?pre-transplant?recipient? status.? The? case? we? report? here? highlighted? the?importance?of?the?middle?hepatic?vein?in?right?liver?living?donor?liver?transplantation. METHODS:?We? illustrated? the? rectification? of? outflow?obstruction? of? the? middle? hepatic? vein? in? the? anterior?sector? of? right? liver? graft? caused? by? technical? error? during?transplantation.? The? rectification? was? performed? with?emergency?re-routing?using?an?artificial?conduit. RESULT:?Congestion? in? the? anterior? sector? of? the? graft?improved? immediately? and? the? patients? postoperative? liver?function?test?results?improved?gradually. CONCLUSIONS:?The? middle? hepatic? vein? is? important? for?effective?drainage?of?the?anterior?sector?of?a?right?liver?graft.?The?re-routing?technique?described?in?the?report?can?also?be?applied? to? cases? in? which? the? middle? hepatic? vein? is? injured?during?hepatectomy?requiring?immediate?reconstruction.