TN02 RADIOLOGICAL ASSESSMENT OF LIVE LIVER AND KIDNEY DONORS

Abstract

Technical success with minimal morbidity for both donor and recipient in live hepatic and renal donor surgery can be achieved by accurate pre‐operative assessment, including high quality imaging of donor hepatic and renal anatomy. Invasive imaging modalities such as angiography and ERCP have been replaced by the non‐invasive imaging modalities multidetector CT (MD‐CT) and MRI.The aims of pre‐operative imaging of potential hepatic donors include the assessment of hepatic vascular anatomy, biliary anatomy, diffuse hepatic parenchymal conditions such as steatosis, focal hepatic lesions and liver volumetry. There are constant improvements in both CT and MR technology and the local choice of modality may be influenced by availability and local expertise. Both MD‐CT and MRI can be used to assess hepatic arterial, portal venous and hepatic venous anatomy as well as liver volumetry. The temporal and spatial resolution of MD‐CT possibly allows more accurate assessment of hepatic arterial anatomy.Biliary anatomy requires accurate assessment as biliary complications are the most common cause of post operative morbidity. MRCP techniques, particularly recent 3‐dimensional free breathing techniques and MD‐CT with either oral or intravenous cholangiographic agents (CTCP) can provide high resolution cholangiographic imaging. Hepatic steatosis involving the donor is qualitatively assessed with chemical shift MR producing most sensitive assessment.MD‐CT is frequently used in the assessment of potential renal donors with arterial, venous and collecting system variants relatively common. Early main renal artery branching, capsular arteries and large systemic venous tributaries all require recognition.