Hepatic arterial mapping by multidetector computed tomographic angiography in living donor liver transplantation
Cihan Duran1, Suleyman Uraz, Mecit Kantarci
1Department of Radiology, Florence Nightingale Hospital, Bilim University, Istanbul, Turkey.
Insights
Computed tomographic angiography (CTA) effectively identifies hepatic artery variations in living liver donors, aiding surgical planning. This noninvasive imaging method confirms anatomical details crucial for successful liver transplantation.
Area of Science:
- Radiology
- Surgical Anatomy
- Transplantation Medicine
Background:
- Living donor liver transplantation requires precise anatomical knowledge of hepatic vasculature.
- Variations in hepatic arterial anatomy can complicate surgical procedures.
Purpose of the Study:
- To document hepatic arterial variations in living liver donors using computed tomographic angiography (CTA).
- To assess the utility of CTA in pre-operative evaluation of hepatic arterial anatomy.
- To correlate CTA findings with intraoperative observations.
Main Methods:
- Retrospective analysis of 100 living liver donor computed tomographic angiography (CTA) scans.
- Evaluation of 16-slice multidetector CT images for hepatic artery variations.
- Comparison of CTA findings with surgical outcomes.
Main Results:
- Hepatic artery variations were identified in 41% of donors.
- CTA findings were consistently confirmed during surgery.
- A low complication rate of 1% was observed, with only one instance of hepatic artery thrombus.
Conclusions:
- Multidetector CTA is a valuable noninvasive tool for imaging hepatic arteries in liver transplant donors.
- Accurate pre-operative assessment of vascular anatomy is critical for successful liver transplantation.
- CTA aids in planning and reduces potential complications associated with hepatic artery variations.
Purpose:
Our aims were to present the hepatic arterial variations that were detected with computed tomographic angiography (CTA) and confirmed by operation in living liver donors and to emphasize the usefulness of CTA in the assessment of hepatic arterial anatomy.
Materials And Methods:
The donors of 100 patients (46 women and 54 men) who had undergone a living donor liver transplantation in a (blinded) hospital between July 2004 and June 2007 were evaluated. The age of the donors ranged from 18 to 63 years (mean, 39 years). The CTA images obtained by a 16-slice multidetector CT before the transplantation procedure were retrospectively evaluated for arterial variations, and the results were compared with the results of the operation.
Results:
In 59 donors (59%), classic hepatic arterial anatomy was observed. In the remaining 41 donors (41%), various arterial variations were determined. In 11 of the donors (11%), variations were not compatible with the description of Michel's classification. In all of our patients, CTA findings were confirmed with operational findings. Our complication rate was 1%. Only 1 of the patients who had undergone the transplantation developed hepatic arterial thrombus, and the remaining 99 patients had no arterial complications.
Conclusions:
The course of the vascular structures before live donor liver transplantation is essential for planning and success of the operation. Our study showed that multidetector CTA can be used successfully in hepatic artery imaging of liver transplantation donors as a noninvasive method.
