Adult-to-adult living donor liver transplantation preoperative survey using MDCT, a single medical center experience in Taiwan
This study evaluated multi-detector computed tomography (MDCT) scans performed on potential living donors for adult-to-adult liver transplantation (LDLT), with the aim of identifying significant findings that could be used to exclude potential transplantation donors. We retrospectively reviewed the...
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Wiley
2018-02-01
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| Series: | Kaohsiung Journal of Medical Sciences |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X17302905 |
| _version_ | 1818246799632105472 |
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| author | Te-Cheng Su Siu-Wan Hung Ming-Cheng Liu Yen-Ting Lin Jeon-Hor Chen Shao-Bin Cheng Clayton Chi-Chang Chen |
| author_facet | Te-Cheng Su Siu-Wan Hung Ming-Cheng Liu Yen-Ting Lin Jeon-Hor Chen Shao-Bin Cheng Clayton Chi-Chang Chen |
| author_sort | Te-Cheng Su |
| collection | DOAJ |
| description | This study evaluated multi-detector computed tomography (MDCT) scans performed on potential living donors for adult-to-adult liver transplantation (LDLT), with the aim of identifying significant findings that could be used to exclude potential transplantation donors. We retrospectively reviewed the medical records of 151 consecutive potential adult donors for LDLT from May 2007 to January 2015. Liver parenchyma steatosis, focal hepatic mass or intraabdominal malignancy, vascular variations, and donor liver volume were evaluated via MDCT. Grounds for excluding potential donors were also recorded and analyzed. Of the 151 potential donors, nine (6.0%) had moderate to severe fatty liver, 37 (24.5%) had hepatic arterial variants, 22 (14.6%) had significant portal venous variants, and more than half were found to have right accessory inferior hepatic vein. No intraabdominal malignancies were found. Eighty-eight potential donors were rejected, with the most common cause being insufficient recipient volume or remnant donor volume (47.7%), moderate to severe parenchymal steatosis (10.2%), and recipient expiration prior to transplantation (8.0%). An additional 16 potential donors were excluded by the surgical team due to the complexity of their portal venous variations. The rate of exclusion by pre-transplant imaging evaluation with MDCT was 33.8%. MDCT can provide accurate quantification of donor liver volume and steatosis severity along with precise demonstration of vascular variants, which are crucial for the preoperative evaluation of LDLT. However, MDCT may be ineffective for evaluating the biliary system without hepatobiliary-excreted contrast agent and has the disadvantage of ionizing radiation. |
| first_indexed | 2024-12-12T14:54:33Z |
| format | Article |
| id | doaj.art-6075cf975a0245a7962a4a433b95dfdc |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-12-12T14:54:33Z |
| publishDate | 2018-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-6075cf975a0245a7962a4a433b95dfdc2022-12-22T00:20:56ZengWileyKaohsiung Journal of Medical Sciences1607-551X2018-02-013429510210.1016/j.kjms.2017.09.007Adult-to-adult living donor liver transplantation preoperative survey using MDCT, a single medical center experience in TaiwanTe-Cheng Su0Siu-Wan Hung1Ming-Cheng Liu2Yen-Ting Lin3Jeon-Hor Chen4Shao-Bin Cheng5Clayton Chi-Chang Chen6Department of Radiology, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Radiology, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Radiology, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Radiology, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Radiology, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Radiology, Taichung Veterans General Hospital, Taichung, TaiwanThis study evaluated multi-detector computed tomography (MDCT) scans performed on potential living donors for adult-to-adult liver transplantation (LDLT), with the aim of identifying significant findings that could be used to exclude potential transplantation donors. We retrospectively reviewed the medical records of 151 consecutive potential adult donors for LDLT from May 2007 to January 2015. Liver parenchyma steatosis, focal hepatic mass or intraabdominal malignancy, vascular variations, and donor liver volume were evaluated via MDCT. Grounds for excluding potential donors were also recorded and analyzed. Of the 151 potential donors, nine (6.0%) had moderate to severe fatty liver, 37 (24.5%) had hepatic arterial variants, 22 (14.6%) had significant portal venous variants, and more than half were found to have right accessory inferior hepatic vein. No intraabdominal malignancies were found. Eighty-eight potential donors were rejected, with the most common cause being insufficient recipient volume or remnant donor volume (47.7%), moderate to severe parenchymal steatosis (10.2%), and recipient expiration prior to transplantation (8.0%). An additional 16 potential donors were excluded by the surgical team due to the complexity of their portal venous variations. The rate of exclusion by pre-transplant imaging evaluation with MDCT was 33.8%. MDCT can provide accurate quantification of donor liver volume and steatosis severity along with precise demonstration of vascular variants, which are crucial for the preoperative evaluation of LDLT. However, MDCT may be ineffective for evaluating the biliary system without hepatobiliary-excreted contrast agent and has the disadvantage of ionizing radiation.http://www.sciencedirect.com/science/article/pii/S1607551X17302905Living donorsLiver transplantationMultidetector computed tomography |
| spellingShingle | Te-Cheng Su Siu-Wan Hung Ming-Cheng Liu Yen-Ting Lin Jeon-Hor Chen Shao-Bin Cheng Clayton Chi-Chang Chen Adult-to-adult living donor liver transplantation preoperative survey using MDCT, a single medical center experience in Taiwan Kaohsiung Journal of Medical Sciences Living donors Liver transplantation Multidetector computed tomography |
| title | Adult-to-adult living donor liver transplantation preoperative survey using MDCT, a single medical center experience in Taiwan |
| title_full | Adult-to-adult living donor liver transplantation preoperative survey using MDCT, a single medical center experience in Taiwan |
| title_fullStr | Adult-to-adult living donor liver transplantation preoperative survey using MDCT, a single medical center experience in Taiwan |
| title_full_unstemmed | Adult-to-adult living donor liver transplantation preoperative survey using MDCT, a single medical center experience in Taiwan |
| title_short | Adult-to-adult living donor liver transplantation preoperative survey using MDCT, a single medical center experience in Taiwan |
| title_sort | adult to adult living donor liver transplantation preoperative survey using mdct a single medical center experience in taiwan |
| topic | Living donors Liver transplantation Multidetector computed tomography |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X17302905 |
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