Review
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Sep 28, 2014; 6(9): 693-707
Published online Sep 28, 2014. doi: 10.4329/wjr.v6.i9.693
Expectations from imaging for pre-transplant evaluation of living donor liver transplantation
Tiffany Hennedige, Gopinathan Anil, Krishnakumar Madhavan
Tiffany Hennedige, Gopinathan Anil, Department of Diagnostic Imaging, National University Health and Yong Loo Lin School of Medicine, Singapore 119074, Singapore
Krishnakumar Madhavan, Department of Department of General Surgery, National University Hospital Singapore, Singapore 119074, Singapore
Author contributions: All the three authors have contributed equally to this work.
Correspondence to: Gopinathan Anil, MD, DNB, FRCR (Lon), FAMS, Department of Diagnostic Imaging, National University Health and Yong Loo Lin School of Medicine, 5 Lower Kent Ridge Road, Singapore 119288, Singapore. ivyanil10@gmail.com
Telephone: +65-97296614 Fax: +65-67797101
Received: February 8, 2014
Revised: March 25, 2014
Accepted: July 15, 2014
Published online: September 28, 2014
Processing time: 229 Days and 11.8 Hours
Abstract

Living donor liver transplant (LDLT) is a major surgical undertaking. Detailed pre-operative assessment of the vascular and biliary anatomy is crucial for safe and successful harvesting of the graft and transplantation. Computed tomography (CT) and magnetic resonance imaging (MRI) are currently the imaging modalities of choice in pre-operative evaluation. These cross-sectional imaging techniques can reveal the vascular and biliary anatomy, assess the hepatic parenchyma and perform volumetric analysis. Knowledge of the broad indications and contraindications to qualify as a recipient for LDLT is essential for the radiologist reporting scans in a pre-transplant patient. Similarly, awareness of the various anatomical variations and pathological states in the donor is essential for the radiologist to generate a meaningful report of his/her observations. CT and MRI have largely replaced invasive techniques such as catheter angiography, percutaneous cholangiography and endoscopic retrograde cholangiopancreatography. In order to generate a meaningful report based on these pre-operative imaging scans, it is also mandatory for the radiologist to be aware of the surgeon’s perspective. We intend to provide a brief overview of the common surgical concepts of LDLT and give a detailed description of the minimum that a radiologist is expected to seek and report in CT and MR scans performed for LDLT related evaluation.

Keywords: Liver transplantation; Pre-living donor liver transplant imaging; Vascular anatomy and variants; Biliary anatomy and variants; Computed tomography; Magnetic resonance imaging

Core tip: Living donor liver transplantation (LDLT) has evolved to a widely accepted therapeutic option. As a radiologist, knowledge of the various anatomical variations and pathological states in both the donor and recipient are imperative to generating a meaningful report in pre-operative evaluation. This paper provides a brief overview of the common surgical concepts of LDLT and gives a detailed description of the minimum that a radiologist is expected to seek and report in computed tomography and magnetic resonance scans performed for LDLT related evaluation.