Figure 6. Sequence of clamping of the portal vein and its branches before reperfusion. (A) After completion of the right portal vein anastomosis. (B) A vascular clamp is applied to the junction of the right portal vein and the main trunk to prevent blood clot released from the portal vein from flushing into the liver graft; the control tape of the venovenous bypass and the cannula were then removed. (C) A vascular clamp is applied to the main trunk. Transient release of the vascular clamp applied to the main portal vein allows blood clot, if any, to come out. The lumen of the portal vein is flushed free of blood clot and fibrin. (D) A vascular clamp is then applied horizontally to the left hepatic vein while the lumen of the main portal vein is filled with heparin-saline. After the left hepatic vein is controlled and the suprahepatic inferior vena cava vascular clamp is released, the vascular clamps controlling the right and main portal veins are removed to allow reperfusion of the graft.