Preoperative Imaging Evaluation of Potential Living Liver Donors: Reasons for Exclusion From Donation in Adult Living Donor Liver Transplantation

Tsang, Leo Leung-Chit; Chen, C.-L.; Huang, Tung‐Liang; Chen, T.-Y.; Wang, C.-C.; Ou, Hsin‐You; Lin, Li; Cheng, Yu‐Fan

doi:10.1016/j.transproceed.2008.07.075

Cited by 62 publications

(43 citation statements)

References 7 publications

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“…; study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; literature research, J. as hepatic steatosis or hepatic fibrosis, were the main reasons for exclusion from donation in potential adult living liver transplantation donors (7)(8)(9). Recently, nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH), has increasingly been recognized as the most common chronic liver disease worldwide, with reports of an increasing prevalence of NASH in the United States (10).…”

Section: Author Contributionsmentioning

confidence: 99%

Combined Use of MR Fat Quantification and MR Elastography in Living Liver Donors: Can It Reduce the Need for Preoperative Liver Biopsy?

Yoon¹,

Lee²,

Suh³

et al. 2015

Radiology

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Purpose:To evaluate the diagnostic performance of magnetic resonance (MR) fat quantification and MR elastography for the assessment of hepatic steatosis and fibrosis in living liver donor candidates. Materials and Methods:This retrospective study was approved by the institutional review board, and the requirement of informed consent was waived. Donors who underwent MR fat quantification and MR elastography at 1.5 T, followed by liver biopsy, were chronologically grouped into test and validation groups. In the test group (n = 362), MR fat fraction and liver stiffness were compared among donors with normal parenchyma (n = 244), simple steatosis (n = 71), steatosis with inflammatory activity (n = 21), nonalcoholic steatohepatitis (n = 17), and fibrosis (n = 9). Diagnostic performance of the two techniques was assessed by using receiver operating characteristic curve analysis for the detection of substantial steatosis (macrovesicular fat  10%) or fibrosis (F1) and was tested in a validation group (n = 34). Results:In the test group, donors with steatosis showed significantly higher fat fraction than donors without steatosis (P , .0001), and donors with fibrosis and nonalcoholic steatohepatitis showed significantly higher liver stiffness values than donors without fibrosis (P , .0001). Areas under the curve were 0.93 (cutoff value . 5.8%) for MR fat quantification and 0.85 (cutoff value . 1.94 kPa) for MR elastography. By using those values, the combination of the two techniques could be used to detect substantial steatosis or fibrosis with 100% sensitivity (12 of 12 patients, 95% confidence interval: 73.4%, 100%) and 100% negative predictive value (15 of 15 patients, 95% confidence interval: 78.0%, 100%) in the validation group. Conclusion:A combination of MR fat quantification and MR elastography can provide sufficient sensitivity to detect substantial steatosis or fibrosis (F1) in liver donor candidates.q RSNA, 2015

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Section: Author Contributionsmentioning

confidence: 99%

Combined Use of MR Fat Quantification and MR Elastography in Living Liver Donors: Can It Reduce the Need for Preoperative Liver Biopsy?

Yoon¹,

Lee²,

Suh³

et al. 2015

Radiology

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“…The latter is essential to preoperative planning; in some cases, the risks that variant anatomy present may also preclude transplantation because of the risk of intra-and postoperative complications in both the donor and recipient. Preoperative imaging of the liver enables detection of abnormalities, such as portal vein thrombosis; vascular anomalies; and biliary anatomic variants in both donors and recipients, as is illustrated by the high frequency of anatomic variants that are seen at preoperative imaging [7][8][9]. Three dimensional (3 D) reconstructed images are very helpful in pre-operative planning of hepatic transplantation and to avoid intraoperative and post procedure complications.…”

Section: Discussionmentioning

confidence: 99%

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2017

Ann Clin Gastroenterol Hepatol

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Purpose: The purpose of the study is to access the prevalence of accessory right inferior hepatic veins and their relevant signifi cance in liver transplantation. Materials and Methods:A retrospective study was done in which the CT of 82 potential liver transplant candidates between January 2012 and March 2013 were reviewed. The presence of the accessory right inferior hepatic vein was examined; the diameters of the accessory inferior hepatic veins and the distance between the point where they open into the inferior vena cava on the coronal plane and to the right hepatic vein-inferior vena cava junction was measured. Results:Out of 82 patients, 42 (51%) had accessory right inferior hepatic veins. Right accessory inferior hepatic veins larger than 3 mm were detected in 23 (28%) patients. The distance of these veins to the right hepatic vein-inferior vena cava junction was more than 4 cm in 13 (15%) patients. Conclusion:The precise preoperative knowledge of accessory right inferior hepatic veins is essential in living donor liver transplantation.

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“…A variety of anomalous branching patterns can affect the surgical approach and even preclude liver donation [12,13]. Magnetic resonance cholangiopancreatography (MRCP) is most commonly used for preoperative assessment of biliary anatomy.…”

Section: Preoperative Assessment Of Biliary Anatomymentioning

confidence: 99%

State of the Art and Future Developments for Surgical Planning in LDLT

et al. 2014

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Living donor liver transplantation (LDLT) is a wellestablished strategy to decrease transplant waiting list mortality. The challenges facing the field relate primarily to donor risk and recipient graft function. The transplant community has developed medical and surgical innovations to address these challenges. This article describes the state of the art and future directions for LDLT surgical planning.

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Preoperative Imaging Evaluation of Potential Living Liver Donors: Reasons for Exclusion From Donation in Adult Living Donor Liver Transplantation

Cited by 62 publications

References 7 publications

Combined Use of MR Fat Quantification and MR Elastography in Living Liver Donors: Can It Reduce the Need for Preoperative Liver Biopsy?

Combined Use of MR Fat Quantification and MR Elastography in Living Liver Donors: Can It Reduce the Need for Preoperative Liver Biopsy?

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State of the Art and Future Developments for Surgical Planning in LDLT

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