Introduction: We present the initial experience of use of ringed PTFE graft for middle hepatic vein (MHV) reconstruction for living donor liver transplantation (LDLT) at Haeundae Paik hospital during two years from the hospital opening. Large vein allograft, especially cryopreserved vein, is suitable for MHV reconstruction, but its supply is often limited in a newly opened hospital. For this reason, ringed PTFE (GORE-TEX®) grafts (10-12 mm in diameter) were used to reconstruct MHV branches for the modified right lobe grafts in our institution. Method: From March 2010 to December 2011, 10 LDLTs and 1 deceased donor LT were performed at our hospital. There were 8 cases of modified right lobe graft (MRL) and 2 cases of dual grafts. 7 ringed PTFE grafts were used in 8 MRL. In one MRL, ringed PTFE did not need due to MHV branches were less than 5 mm in diameter. 6 of 7 cases were analyzed. One case was excluded because retransplantation was performed 3 weeks later of LDLT due to hepatic artery rupture. Results: The patency of the ringed PTFE graft was checked with computed tomography scan of the liver. The 1-month, 4-month and 6-month patency rates of the ringed PTFE grafts were 100% (6/6), 50% (3/6) and 16.6% (1/6) respectively. All showing late obstruction (over 4 months) were asymptomatic (no elevated liver enzyme) and did not have congestion of the liver on CT scans. There were no specific complications related using ringed PTFE graft and no patient death, chronic graft dysfunction or graft loss during follow up period. Conclusion: Although small cases, the early ringed PTFE graft function was excellent and late obstruction of ringed PTFE graft had no specific clinical problems on graft function or patient survival. Ringed PTFE graft seems to be a good alternative material for MHV reconstruction.