Imaging for right lobe living donor liver transplantation

The authors describe their experience using multidetector, multiphase computed tomography (CT) for the preoperative evaluation of donors undergoing adult right lobe liver transplantation. The marked improvement in image resolution has been extremely valuable in delineating small hepatic arterial structures, including accessory and replaced vessels. Assessment of liver parenchyma is valuable in determining the presence of steatosis or other unexpected abnormalities. Measurement of total liver volume is highly accurate and reproducible. Virtual hepatectomy can be performed in an avascular plane between the right and left lobes, to the right of the middle hepatic vein. Knowledge of the resultant right and left lobe volumes is critical in patient selection. Multidetector, multiphase CT, as a single imaging modality, provides a minimally invasive comprehensive pre-operative evaluation that can be expected to have a major impact on patient selection and surgical planning.