Document Detail


Three-dimensional computed tomography scan analysis of hepatic vasculatures in the donor liver for living donor liver transplantation.
MedLine Citation:
PMID:  20818744     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Because hepatic vasculatures exhibit variations, a preoperative evaluation of the vascular anatomy and an estimation of the volume of the liver graft are essential for successful adult living donor liver transplantation. Using 3-dimensional (3D) computed tomography (CT), we analyzed the volumetric and anatomical relationship of the hepatic vasculatures of liver grafts. The livers of 223 potential donors were analyzed by 3D CT. Volumetric analysis was performed for each hepatic vein and its tributaries. The anatomy of the portal vein and hepatic artery was assessed along with the biliary system via intraoperative cholangiography in 110 recipients. On the basis of the anatomical presentation of the inferior right hepatic vein (IRHV), the hepatic veins were classified as follows: in type I, the IRHV was absent; in type II, the IRHV was smaller than the right hepatic vein (RHV); and in type III, the IRHV was greater than or equal to the RHV in size. The drainage volume of the middle hepatic vein (MHV) and especially its tributaries in the right lobe increased with the size of the IRHV (P < 0.001). In type III hepatic veins with a large IRHV (17% of the donors), the MHV tributaries had the largest drainage volume in the right lobe (41.2% +/- 11.8%). Furthermore, type III hepatic veins typically exhibited biliary variations in 75% of the donors. No correlation was observed between variations in the hepatic artery and portal vein. In conclusion, a right lobe graft with a large IRHV is accompanied by a large drainage volume via the MHV and by bile duct variations in 17% of livers. Therefore, anatomical and volumetric analysis is important for preoperative evaluations.
Authors:
Koichiro Uchida; Masahiko Taniguchi; Tsuyoshi Shimamura; Tomomi Suzuki; Kenichiro Yamashita; Minoru Ota; Toshiya Kamiyama; Michiaki Matsushita; Hiroyuki Furukawa; Satoru Todo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  16     ISSN:  1527-6473     ISO Abbreviation:  Liver Transpl.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2010-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1062-8     Citation Subset:  IM    
Copyright Information:
(c) 2010 AASLD.
Affiliation:
Department of General Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biliary Tract / abnormalities,  radiography
Hepatic Artery / abnormalities,  radiography
Hepatic Veins / abnormalities,  radiography
Humans
Imaging, Three-Dimensional*
Japan
Liver / blood supply*,  radiography*
Liver Transplantation*
Living Donors*
Logistic Models
Portal Vein / abnormalities,  radiography
Predictive Value of Tests
Preoperative Care
Radiographic Image Interpretation, Computer-Assisted
Tomography, X-Ray Computed*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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