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Liver transplantation: preoperative CT evaluation.

H K Pannu1, W R Maley, E K Fishman

  • 1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287, USA. hpannu@jhmi.edu

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|October 13, 2001
PubMed
Summary

Computed tomography (CT) is essential for evaluating liver transplant recipients and living donors. This imaging technique provides crucial anatomical and pathological details, aiding surgical planning and improving patient outcomes in liver transplantation.

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Area of Science:

  • Radiology
  • Hepatology
  • Surgical Oncology

Background:

  • Liver transplantation offers a >80% 1-year survival rate for chronic liver disease and failure.
  • Orthotopic liver transplantation utilizes cadaveric or living adult donors.
  • Pre-transplant recipient and donor evaluation is critical for successful outcomes.

Purpose of the Study:

  • To highlight the utility of computed tomography (CT) in pre-transplant evaluations.
  • To detail the specific recipient information obtainable via CT.
  • To outline the donor-specific information provided by CT for living donors.

Main Methods:

  • Review of surgical approaches and imaging findings in liver transplantation.
  • Computed tomography (CT) for recipient assessment.

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  • Computed tomography (CT) for living donor assessment.

    • Main Results:

    • CT identifies recipient details: caudate lobe size, malignancy exclusion, venous patency, varices, arterial patency, aneurysm exclusion, and shunt position.
    • CT reveals living donor anatomy: variant hepatic arteries, segment IV artery source, hepatic vein anatomy, portal vein/hepatic duct trifurcation, liver volume, and fatty changes.
    • Imaging findings directly influence surgical management decisions.

    Conclusions:

    • Computed tomography (CT) is indispensable for comprehensive pre-liver transplant evaluations.
    • CT provides vital anatomical and pathological data for both recipients and living donors.
    • Effective use of CT imaging enhances surgical planning and optimizes liver transplantation outcomes.