Multi-detector row computed tomography was performed for the preharvest evaluation of 14 potential living liver donors. Both a biliary contrast agent and a conventional iodin-ated contrast agent were administered intravenously. This protocol included acquisition of three subsequent scans and allowed accurate assessment of the hepatic parenchymal morphology and volumetrics and a detailed analysis of the biliary and vascular anatomies.
As a reflection of the severe shortage of cadaveric liver transplants, living donor liver transplantation has evolved into a more frequently considered therapeutic option in recent years (1-4). This procedure allows healthy adults to donate a portion of their liver to compatible recipients with end-stage liver disease (5).
After overcoming the psychologic barriers of agreeing to donate part of an organ, the potential liver donor must undergo an extensive and costly preharvest assessment, during which a majority of candidates are eliminated mostly owing to unfavorable hepatic parenchymal, biliary, or vascular morphologies (6). The current evaluation protocol proceeds in a stepwise fashion and includes computed tomography (CT) to accomplish liver planimetry and to exclude parenchymal lesions, endoscopic retrograde cholangiopancreatography (ERCP) to assess the biliary anatomy, and conventional digital subtraction angiography (DSA) to display the hepatic vascular system. Accurate knowledge of the hepatic parenchymal and vascular anatomies is crucial to reduce the frequency of complications during and after transplantation (7-9).
The purpose of our study was to evaluate an all-in-one three-phase dual-enhancement multi-detector row CT approach that combines analysis of the hepatic parenchyma with assessment of the vascular and biliary anatomies.