Radiographic features of potential donor livers that precluded donation.

Abstract

The objective of our study was to catalog the anatomic features shown on preoperative CT that precluded living-donor liver donation. We retrospectively reviewed the records of 159 consecutive candidates who were evaluated for potential right or left lobe liver donation from November 2007 to January 2012 using MDCT angiography and cholangiography. For the potential donors who were excluded secondary to findings depicted on preoperative imaging, we determined which findings precluded donation. In two (1%) patients who had no prohibitive preoperative imaging findings, anatomic abnormalities were detected intraoperatively that precluded transplantation. Sixty-one (38%) candidates were excluded from liver donation on the basis of imaging findings. Of these patients, 40 (66%) had inadequate liver volume, 14 (23%) had vascular or biliary variants, five (8%) had steatosis, and two (3%) were found to have renal cell carcinoma. Arterial and biliary variants were the most common reason for exclusion based on anatomic findings. Inadequate liver volume was the most common reason for exclusion based on preoperative imaging. Arterial and biliary anatomic variants precluded both right and left lobe transplantation in a number of cases.