Learning objectives
The primary aim in imaging candidates for liver transplant is,
improving long-term survival
lowering risk of toxicity in donors and recipients
assessment of the potential living donor
thorough and detailed report on normal variant anatomy which will implicate clinical/surgery outcome
detection of both early and late complications.
Liver transplantation requires a multidisciplinary collaboration between the radiologist, hepatologist, clinical oncologist, and transplant surgeon. Radiologists play an essential role in identifying normal and abnormal variant anatomy and other conditions that may be present, a task that is...
Background
All through the life cycle of liver trasnplant donor and recipient radiology and thus radiologists play a pivotal role.
Liver transplantation is one of the greatest advances of the past 3 decades for the care of patients with hepatic failure. Liver transplantation is an excellent, and sometimes life-saving, treatment option for patients with acute and chronic end-stage organ diseases.
We have discussed the normal and variant anatomy of the vessels of significance in liver transplantation and how they affect the course or planning of surgery...
Findings and procedure details
Assessment of hepatic vascular anatomy in the donor is very important for optimal donor performance after hepatectomy and successful liver transplantation in the recipient. Only 35% of the population has been shown to possess conventional HA, HV and PV anatomy, with variant HA and HV each found in 40% of the population, and variant PV anatomy found in 20%.Therefore, knowledge and awareness of variant hepatic vasculature is critical in liver donor evaluation and surgical planning.
Computerized tomographic angiography (CTA) helps to clearly delineate the vascular...
Conclusion
Radiologists also must understand how their findings affect patient preparation. An awareness of the range of indications for liver transplantation, imaging modalities, and current surgical techniques is important to properly evaluate a patient who may undergo liver transplantation.
Knowledge on the route and branch variations of the vessels mntioned in our review can be beneficial for making vessel anastamoses during liver transplantations, preventing vascular injuries during surgical interventions and also for educational purposes.
Personal information and conflict of interest
F. Abubacker Sulaiman; Chennai, TN/IN - nothing to disclose A. Asokan; Chennai/IN - nothing to disclose A. Rajendran; Chennai, TA/IN - nothing to disclose A. Chelladurai; Chennai/IN - nothing to disclose V. K. Jagan; Coimbatore/IN - nothing to disclose A. N. Parimalai; Chennai, TA/IN - nothing to disclose N. Chidambaranathan; Chennai, TAMIL NADU/IN - nothing to disclose
References
(1) Pre-hepatic and pre-pancreatic transplant donor evaluation - Cardiovascular diagnosis and therapy (Vascular imaging), August 2019.
(2) Anatomy of liver arteries for interventional radiology- Diagnostic and interventional imaging, June 2016.
(3) Panagouli E, Venieratos D, Lolis E, Skandalakis P. Variations in the anatomy of the celiac trunk: A systematic review and clinical implications.Ann Anat.2013;195(6):501–511.
(4)Starzl TE, Groth CG, Brettschneider L, et al. Orthotopic homotransplantation of the human liver. Ann Surg 1968;168:392-415.
(5)Vagefi PA, Ascher NL, Freise CE, et al. Use of living donor liver transplantation...