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DOI: 10.1148/rg.254045032
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RadioGraphics 2005;25:1017-1030
© RSNA, 2005

EDUCATION EXHIBIT

Multidetector CT in the Evaluation of Potential Living Donors for Liver Transplantation1

Ana Alonso-Torres, MD, Jaime Fernández-Cuadrado, MD, Inmaculada Pinilla, MD, Manuel Parrón, MD, Emilio de Vicente, MD and Manuel López-Santamaría, MD

1 From the Departments of Radiology (A.A.T., J.F.C., I.P., M.P.) and Pediatric Surgery (M.L.S.), Hospital Universitario La Paz, Paseo de la Castellana 261, Madrid 28046, Spain; and the Department of General Surgery, Hopital Ramón y Cajal, Madrid, Spain (E.d.V.). Presented as an education exhibit at the 2003 RSNA Annual Meeting. Received March 11, 2004; revision requested June 30; final revision received October 27; accepted October 28. All authors have no financial relationships to disclose. Address correspondence to A.A.T. (e-mail: ana.at{at}terra.es).

Living donor liver transplantation is increasingly being used to help compensate for the increasing shortage of cadaveric liver grafts. However, the extreme variability of the hepatic vascular systems can impede this surgical procedure. Evaluation of potential living donors was conducted in which a two-detector-row computed tomographic (CT) scanner was used to obtain arterial phase and portal dominant phase images following the intravenous injection of contrast material, after which three-dimensional maximum-intensity-projection and volume-rendered images were created. The vascular anatomy was evaluated, with special attention given to the origin and course of the artery to segment IV and the presence of variants, especially those considered relative or absolute contraindications for donation, those requiring reconstruction, or those potentially altering the surgical approach. In addition, graft and remnant liver volumes were determined and the liver parenchyma evaluated. Multidetector CT is proving to be valuable in the evaluation of potential living liver donors, contributing to donor safety and providing comprehensive information about the hepatic vascular anatomy, the liver parenchyma, and graft and remnant liver volume. This information is critical in choosing the most suitable potential donor, in surgical planning, and in obtaining an optimal graft that maintains the balance between blood supply and venous drainage.

© RSNA, 2005






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