Imaging of living donor liver transplantation = La valutazione radiologica nel trapianto di fegato da donatore vivente

Purpose. This paper presents our experience in the evaluation of 23 potential living liver donors examined from January 2001 to December 2002. Materials and methods. Between January 2001 and December 2002, a total of 23 potential living liver donors were evaluated (20 men, 3 women; mean age 30 years) with MSCT and MR. Vascular reconstructions (MIP and Thin MIP) and volumetric evaluation of liver "in toto" and of the right hepatic lobe to be harvested were obtained with CT. MR was performed with in- and out-of-phase GE acquisitions in order to detect liver steatosis and with SSFSE T2 weighted thick-slab (50 mm) coronal acquisitions to obtain MR cholangiography. MR cholangiography was also obtained with post-contrast (Gd-BOPTA 90 min) 3D GE thin (1.5 mm) coronal sequences. Ten potential living liver donors also underwent angiography. Results. The radiological examinations demonstrated abnormalities of the portal vein bifurcation in 7/23 potential living liver donors, variants of the arterial anatomy in 5/23 and abnormalities of the biliary anatomy in 20/23. One case showed gallbladder dysmorphism. The MR examinations led to the exclusion from the transplantation of one potential living liver donor owing to the detection of liver steatosis that was subsequently confirmed by biopsy. 7/23 potential living liver donors were considered eligible for the surgical procedure and underwent preoperative colour Doppler sonography and intraoperative cholangiography. Conclusions. The diagnostic protocols used at our centre provide the clinician with important information and an exhaustive picture of the hepatic anatomy to evaluate the inclusion of potential living liver donors in the transplantation program.