The Efficacy of Pre-transplant Radiologic Evaluation for Graft Volume and Anatomy in Living Donor Liver Transplantation.
- Author:
Man Ki JU
1
;
Myoung Soo KIM
;
Gi Hong CHOI
;
Hye Kyung CHANG
;
Hyung Jun AHN
;
Yu Seun KIM
;
Jin Sub CHOI
;
Soon Il KIM
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. soonkim@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Liver transplantation;
Anatomy;
Volumetry
- MeSH:
Bile Ducts;
Drainage;
Hepatic Artery;
Hepatic Veins;
Humans;
Imaging, Three-Dimensional;
Liver Transplantation*;
Liver*;
Living Donors*;
Prospective Studies;
Residual Volume;
Tissue Donors;
Transplants*
- From:The Journal of the Korean Society for Transplantation
2007;21(1):128-134
- CountryRepublic of Korea
- Language:Korean
-
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.
