Currently, the only therapeutic option for children with ESLD is LT.Overall survival of the patient and the liver graft directly depends on several potential complications during and after transplantation.The most threatening complications are arterial and venous thrombosis, anastomotic stenosis, and kinking of vessels. 1 Other important perioperative concerns are extensive hemorrhage, infection, and early rejection. To minimize the perioperative complication risk, a thorough preoperative work-up is necessary.Prior to LT, the anatomy and patency of the hepatic artery, portal vein, liver veins, and inferior caval vein need to be assessed. Of these, the hepatic artery anatomy is the most challenging to image.Hepatic artery variants, such as accessory vessels or replacement of the artery where the hepatic artery origin is not the coeliac trunk, have been reported to occur in up to 45% of patients. 2,3 By identifying vascular variants and vessel caliber, the hepatobiliary surgeon is able to select the largest caliber artery for anastomosis, decide on suitability for a match with a living donor graft, and plan required microvascular reconstructions. 4