The utility of MRCP in preoperative mapping of biliary anatomy in adult-to-adult living related liver transplant donors.
OBJECTIVE
To assess the utility of magnetic resonance cholangiopancreatography (MRCP) in preoperative mapping of biliary anatomy in adult-to-adult living related liver transplant (LRLT) donors.


METHODS
From 57 potential donors with preoperative MRCP, 27 cases (16 men, 11 women, age range 22-51 years, mean 37.2 years) underwent right lobe resection and had intraoperative cholangiography (IOC) for comparison. The MRCP and IOC reports were retrospectively reviewed in all 27 cases. The MRCP was performed on 1.5 Tesla MR magnets using breath-hold heavily T2-weighted sequences in axial/coronal thin sections, and variable-thickness rotating slabs. The accuracy of preoperative MRCP for biliary mapping in potential LRLT donors was analyzed compared to the IOC findings.


RESULTS
Of 27 donors, 26 (96.3%) had MRCP which showed adequate information of central intrahepatic biliary anatomy. Of these, 19 had normal bifurcation confirmed by IOC, and single biliary anastomosis was created in the recipient at transplantation. MRCP correctly predicted 17 of 19 normal cases (sensitivity for normals: 89.5%). In seven donors with variant biliary anatomy, two separate biliary anastomoses were performed in the recipient. MRCP correctly predicted five of seven variants (sensitivity for variants: 71.4%). Overall, MRCP had an accuracy 84.6% (22/26).


CONCLUSIONS
MRCP has potential in the preoperative assessment of nondilated bile ducts in LRLT donors, however further improvements are desired to increase its quality and accuracy.
Limanond
Piyaporn
P
Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California 90005-1721, USA.
Raman
Steven S
SS
Ghobrial
R Mark
RM
Busuttil
Ronald W
RW
Lu
David S K
DS
D000328:Adult; D001659:Biliary Tract / Q000033:anatomy & histology*; D002758:Cholangiography; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies