Preoperative liver donor evaluation: Imaging and pitfalls

This article discusses the rationale behind living (related) donor liver transplantation, the role of imaging in the preoperative evaluation of the potential donor, and the currently available imaging modalities for fulfilling this task. Furthermore, the normal hepatic vascular and biliary anatomy, as seen on imaging, is reviewed and the most common anomalies are highlighted. Finally, critical concepts in the diagnostic evaluation of a donor are discussed with special emphasis on how to accurately measure liver volumes. (Liver Transpl 2003;9:S6‐S14.)

[1]  H. Hussain,et al.  Imaging of hepatic transplantation. , 1998, Clinics in liver disease.

[2]  G. Remuzzi,et al.  Strategies for making more organs available for transplantation. , 2000, The New England journal of medicine.

[3]  P. Bret,et al.  Intrahepatic portal venous variations: prevalence with US. , 1992, Radiology.

[4]  C. Couinaud.  [A "scandal": segment IV and liver transplantation]. , 1993, Journal de chirurgie.

[5]  I R Kamel,et al.  Imaging for right lobe living donor liver transplantation. , 2001, Seminars in liver disease.

[6]  T. Starzl,et al.  CLINICAL PRESENTATION OF HEPATIC ARTERY THROMBOSIS AFTER LIVER TRANSPLANTATION IN THE CYCLOSPORINE ERA , 1985, Transplantation.

[7]  P. Ros,et al.  Current techniques of computed tomography. Helical CT, multidetector CT, and 3D reconstruction. , 2002, Clinics in liver disease.

[8]  V. Mazzaferro,et al.  Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. , 1996, The New England journal of medicine.

[9]  N. Rofsky,et al.  Comparison between in-phase and opposed-phase T1-weighted breath-hold FLASH sequences for hepatic imaging. , 1996, Journal of computer assisted tomography.

[10]  S. Kawasaki,et al.  Donor selection for living-related liver transplantation. , 1997, Transplantation proceedings.

[11]  T. Winter,et al.  Hepatic arterial anatomy in transplantation candidates: evaluation with three-dimensional CT arteriography. , 1995, Radiology.

[12]  L Axel,et al.  Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease. , 1980, Radiology.

[13]  A. Andriulli,et al.  Percutaneous biopsy in diffuse liver disease: increasing diagnostic yield and decreasing complication rate by routine ultrasound assessment of puncture site. , 1996, The American journal of gastroenterology.

[14]  Chao-Long Chen,et al.  Magnetic resonance of the hepatic veins with angular reconstruction: application in living-related liver transplantation. , 1999, Transplantation.

[15]  P. Ros,et al.  Anatomic variants of the biliary tree: MR cholangiographic findings and clinical applications. , 2001, AJR. American journal of roentgenology.

[16]  G. Gazelle,et al.  Cholangiographic segmental anatomy of the liver. , 1994, Radiographics : a review publication of the Radiological Society of North America, Inc.

[17]  R. Nelson,et al.  Imaging in the preoperative evaluation of adult liver-transplant candidates: goals, merits of various procedures, and recommendations. , 1995, AJR. American journal of roentgenology.

[18]  J R Lake,et al.  Functional analysis of grafts from living donors. Implications for the treatment of older recipients. , 1996, Annals of surgery.

[19]  N. Michels,et al.  Newer anatomy of the liver and its variant blood supply and collateral circulation. , 1966, American journal of surgery.

[20]  K. Hayashi,et al.  Evaluation of aberrant bile ducts before laparoscopic cholecystectomy: helical CT cholangiography versus MR cholangiography. , 2000, AJR. American journal of roentgenology.

[21]  M. Choti,et al.  Variations in the intrahepatic portions of the hepatic and portal veins: findings on helical CT scans during arterial portography. , 1995, AJR. American journal of roentgenology.

[22]  C. Tiribelli,et al.  Proton MR spectroscopy in quantitative in vivo determination of fat content in human liver steatosis , 1995, Journal of magnetic resonance imaging : JMRI.

[23]  S. Topp,et al.  Split liver transplantation (SLT). , 2000, Annals of transplantation.

[24]  S. Kawasaki,et al.  Calculation of child and adult standard liver volume for liver transplantation , 1995, Hepatology.

[25]  P. Mergo,et al.  Imaging of Diffuse Liver Disease , 2001, Radiologic clinics of North America.

[26]  G. Bannura,et al.  Radiological anatomy of the biliary tract: Variations and congenital abnormalities , 1983, World Journal of Surgery.

[27]  G. Everson,et al.  Adult living donor liver transplantation using a right hepatic lobe. , 1998, Transplantation.

[28]  M. Makuuchi,et al.  Initial experience with 40 cases of living-related donor liver transplantation at the University of Tokyo. , 1999, Transplantation proceedings.

[29]  Inda,et al.  The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. , 1999, The New England journal of medicine.

[30]  C. Thomsen,et al.  Quantification of liver fat using magnetic resonance spectroscopy. , 1994, Magnetic resonance imaging.

[31]  J. Debatin,et al.  Right‐lobe living related liver transplantation: Evaluation of a comprehensive magnetic resonance imaging protocol for assessing potential donors , 2002, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[32]  R. Fisher,et al.  Selection and outcome of living donors for adult to adult right lobe transplantation. , 2000, Transplantation.

[33]  Dixon Ak,et al.  Computed Tomography of the Liver in Wilson Disease , 1984, Journal of computer assisted tomography.

[34]  M. Rosen,et al.  Imaging of Hepatic Steatosis , 2001, Seminars in liver disease.

[35]  S. Goldberg,et al.  Accuracy of volumetric measurements after virtual right hepatectomy in potential donors undergoing living adult liver transplantation. , 2001, AJR. American journal of roentgenology.

[36]  S. Fan,et al.  Adult-to-adult living donor liver transplantation using extended right lobe grafts. , 1997, Annals of surgery.

[37]  Fat suppression by saturation/opposed-phase hybrid technique: spin echo versus gradient echo imaging. , 1995, Magnetic resonance imaging.

[38]  A. Fulcher,et al.  Right lobe living donor liver transplantation: preoperative evaluation of the donor with MR imaging. , 2001, AJR. American journal of roentgenology.

[39]  K. Batts,et al.  Use of fatty donor liver is associated with diminished early patient and graft survival. , 1996, Transplantation.