J Korean Soc Transplant.  2007 Jun;21(1):128-134.

The Efficacy of Pre-transplant Radiologic Evaluation for Graft Volume and Anatomy in Living Donor Liver Transplantation

• Ju MK
• Kim MS
• Choi GH
• Chang HK
• Ahn HJ
• Kim YS
• Choi JS
• Kim SI

Abstract

PURPOSE: For securing donor safety in living donor liver transplantation (LDLT), we must know the anatomy of hepatobiliary and vascular structures as well as donor-recipient hepatic volume profile. The purpose of this study was to ascertain the role of donor-recipient evaluation by using pre-operative radiologic studies.
METHODS
Prospective pre-operative analyses of 94 LDLT candidate pairs (74 recipients and 94 donors) were performed. Tomographic images were reconstructed by 3-dimensional images and used as a resource of calculation of liver volume profile and anatomic structure evaluation.
RESULTS
The percentage of anatomical variation in portal, hepatic vein, hepatic artery and bile duct were 20.2, 41.5, 21.3 and 33.0%, respectively. Among 94 cases, 52 (55.4%) potential donors were unacceptable for LDLT due to a various reasons. The leading cause of unacceptability of donor was anatomical variation (n=24, 25.5%) such as anatomical variation of middle hepatic vein drainage patterns (n=20, 21.3%). Too small residual volume of donor (n=17, 18.1%) and 'small-for-size' (n=5, 5.3%) were also considered criticalcauses of unacceptable donor. Only 19 out of 94 cases underwent suc-cessful living donor right hepatic lobe transplantation.
CONCLUSION
Pre-transplant evaluations of liver volume and anatomic structure by using three-dimensional imaging study and computerized volume measurement system is useful for performing safe LDLT.

Keyword

Liver transplantation; Anatomy; Volumetry

MeSH Terms

Bile Ducts
Drainage
Hepatic Artery
Hepatic Veins
Humans
Imaging, Three-Dimensional
Liver Transplantation*
Liver*
Living Donors*
Prospective Studies
Residual Volume
Tissue Donors
Transplants*