Living related liver transplantation: preoperative magnetic resonance imaging for assessment of hepatic vasculature of donor candidates.

Full Abstract

PURPOSE:
To evaluate the accuracy of magnetic resonance angiography (MRA) for preoperative assessment of hepatic vascular anatomy in liver donors before living related liver transplantation.

MATERIAL AND METHODS:
A total of 55 consecutive living liver donors (mean age 42 years, range 18-68 years) underwent multiphase contrast-enhanced MRA of the hepatic vessels. Two readers categorized vessel visualization on a five-point scale and recorded vascular anatomy or variations thereof for the arterial, portal venous and venous systems. All 55 living liver donors subsequently underwent right hemihepatectomy for hemiliver donation, and preoperative MRA results were correlated with surgical findings.

RESULTS:
Overall vessel visualization assessment demonstrated good or very good ratings for the majority of patients. For hepatic arteries, the mean score was 4.4+/-0.8 (mean+/-standard deviation), and for the portal venous and venous systems it was 4.6+/-0.7 and 4.3+/-0.8, respectively. Among all 55 donors, 16 (29%) demonstrated accessory or replaced hepatic arteries, and seven (13%) and 20 (36%) donors had surgically relevant portal vein (trifurcation or early right posterolateral branching types) and hepatic vein variations, respectively. Correlation coefficients between MRA and surgery were 0.94, 1.00 and 0.91 for hepatic arteries, portal veins and hepatic veins, respectively.

CONCLUSION:
In the preoperative evaluation before living related liver donation, contrast-enhanced MR angiography was a highly accurate, noninvasive tool for visualizing the hepatic vasculature and variations thereof in liver donor candidates.

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Author information

Author/s: Streitparth, F (F); Pech, M (M); Figolska, S (S); Denecke, T (T); Grieser, C (C); Pascher, A (A); Jonas, S (S); Langrehr, J (J); Ricke, J (J); Neuhaus, P (P); Felix, R (R); Hänninen, Lopez E (LE);

Affiliation: Department of Radiology, Charité Medical University Center, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany.

Journal and publication information

Publication Type: Evaluation Studies; Journal Article

Journal: Acta radiologica (Stockholm, Sweden : 1987) (Acta Radiol), published in Sweden. (Language: eng)

Reference: 2007-Feb; vol 48 (issue 1) : pp 20-6

Dates: Created 2007/02/27; Completed 2007/03/30;

PMID: 17325920, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Adult
Aged
Contrast Media - administration & dosage
Gadolinium DTPA - administration & dosage
Hepatectomy
Hepatic Artery - anatomy & histology; radiography
Hepatic Veins - anatomy & histology; radiography
Humans
Liver - anatomy & histology; blood supply

Liver - anatomy & histology; blood supply
Liver Transplantation - statistics & numerical data
Living Donors - statistics & numerical data
Magnetic Resonance Angiography - methods
Middle Aged
Observer Variation
Portal Vein - anatomy & histology; radiography
Preoperative Care - methods
Radiographic Image Enhancement - methods
Reproducibility of Results

Associated Chemicals: Contrast Media (0) ; Gadolinium DTPA (80529-93-7)

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