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Article Type

Original Study

Abstract

Objectives To assess the role of multidetector computed tomography (MDCT) angiography in the preoperative mapping of hepatic vascular anatomy in potential living liver donors, identification of anatomical variants that influence the donor selection and surgical planning. Background Liver transplantation became the ultimate solution for decompensating liver diseases. Donor«SQ»s safety and selection protocols are primary concerns. Thus, preoperative evaluation of the hepatic vascular anatomy is crucial to minimize mortality, morbidity, and post-transplant complications. Patients and methods Evaluation of 20 potential living donors was performed using 64-row MDCT scanners, obtaining hepatic arterial and portovenous phases. The arterial anatomy was classified according to the Michels classification. The portal venous anatomy was assessed and classified according to the Cheng classification. The hepatic venous anatomy was evaluated with special attention paid to the middle hepatic vein anatomy. Results In our study, out of 20 liver transplantation potential donors, 11 (55%) showed a classic arterial anatomy, whereas nine (45%) showed some type of anatomical variant. Replaced right hepatic artery from the superior mesenteric artery was the most common (three donors, 15%). The classic portal venous anatomy was found in 16 candidates (80%), whereas its variants were detected in four cases (20%). The standard hepatic venous anatomy was found in 14 candidates (70%). Six individuals (20%) had significant accessory hepatic veins. Middle hepatic vein confluence was late in four candidates (20%). An accessory inferior right hepatic vein was the most common accessory hepatic vein that was detected in five cases (25%). Conclusion 64-row MDCT is essential in the preoperative evaluation of potential liver donors. It is a noninvasive comprehensive evaluation tool that can show the hepatic vascular anatomic details with precise relationship to the liver parenchyma.

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