Role of multidetectorct in evaluation of liver transplantation donors

Abstract EN

Several factors have contributed to an increasing demand for liver transplantation including an increasing incidence of cirrhosis caused by hepatitis C and the early detection of small hepatomas that are potentially curable with transplantation.

Living donors can help alleviate the shortage of available livers for transplantation.

Multidetector CT is a technologic advance that permits highspeed and high-resolution helical imaging of the entire liver volume during a single breath-hold.

Rapid helical data acquisition has resulted in increased body coverage, decreased motion artifact, better use of contrast bolus, and multiphase organ scanning that allows accurate vascular mapping.

The combination of fast helical scanning and image processing in three-dimensional (3D) and mul planar reconstructions has resulted in dramatic improvement of image quality and the ability to depict fine anatomic-vascular detail.

Materials and Methods: The study included 50 poten al living liver donors to asses the impact of multidetector multiphase CT in facilitating patient selection and surgical planning in potential donors being evaluated for living adult right lobe liver transplantation.

Results: the mean age of the donors was 27.4 years including 28 females and 22 males.

Calculated total liver volumes mean was 1523 +/- 239 gm , right lobe mean weight with middle hepatic vein was 893 +/- 153 gm and 621 +/-172 gm without middle hepa c vein.

intra opera ve mean gra weight was 1043.46 +/-163.77 gm while that measured intra opera vely had a mean weight of 853.14 +/- 122.69 with a mean weight difference of 190.32 gm.

CT calculated gra recipient weight ra o was 1.34 while actual GRWR was 1.068.

meal L/S ra o 1.12.

The classic anatomy of right main hepa c artery origina ng from the caeliac trunk (Michel type I) is seen in 35 cases (70%) , while RHA origina ng from SMA (Michel s' type III) seen in 8 cases (16%) , CHA origina ng from SMA (Michel s' type IX) in 4 cases (8%) , RHA from the aorta (Michel s' type XI) in 2 cases (4%) and two LHAs (Michel s' type VII) in one case (2%).

Varia on in portal venous anatomy occurred in 20 % of pa ents and includes: 1-trifurca on of the portal vein (type B) in 9 cases (18%) 2-posterior right portal vein from main portal vein (separate branch for posterior inferior segment , segment VII) Type D in 1case (2%) .

hepa c veins showed early confluence to the right was present in 3 pa ents (6%) and accessory inferior right hepa c vein was detected in 2 pa ents (4%) Conclusion: Multidetector CT is a valuable tool in the evaluation of potential living liver donors that provides complete and comprehensive information on the hepatic vascular anatomy, the liver parenchyma, and volumetric measurements.