title: Living donor candidates for right hepatic lobe transplantation: evaluation at CT cholangiography--initial experience.
abstract: OBJECTIVE
  To retrospectively evaluate computed tomographic (CT) cholangiography in the depiction of second-order biliary tract anatomy in living donor candidates for right hepatic lobe transplantation.
  
  
  METHODS
  Human research committee approval was obtained, informed consent was not required, and the study was compliant with the Health Insurance Portability and Accountability Act. The authors identified all living right-lobe liver donor candidates who underwent CT cholangiography at their institution between October 2001 (when CT cholangiography was introduced at the institution) and March 2003 (n = 62). There were 41 men (mean age, 36 years; range, 18-55 years) and 21 women (mean age, 40 years; range, 22-55 years). Two readers in consensus rated quality of second-order bile duct visualization at CT cholangiography on a four-point scale (0, not seen; 3, excellent visualization) and noted the presence of variant second-order biliary tract branching anatomy. CT cholangiography findings were compared with those at surgery in subjects who underwent right hepatic lobe retrieval (n = 24). In addition, adult donors who underwent right hepatic lobe retrieval between January 2000 and March 2003 (29 men, mean age, 35 years [range, 20-52 years]; 18 women, mean age, 38 years [range, 23-54 years]) were identified. Numbers of donors who underwent intraoperative cholangiography before and after the introduction of CT cholangiography were compared by using the Fisher exact test.
  
  
  RESULTS
  The mean second-order bile duct score at CT cholangiography was 2.9 (range, 2-3). Of 24 subjects who underwent right lobe retrieval, biliary tract anatomy determined at CT cholangiography was concordant with findings at surgery in 23 (96%). Variant second-order branching anatomy was seen in 13 subjects (54%) at surgery; one variant branch was missed at CT cholangiography. Of 47 subjects who underwent right hepatic lobe retrieval, significantly fewer subjects required conventional intraoperative cholangiography after the introduction of CT cholangiography (three of 24 subjects [12%]) than before (23 of 23 subjects; P < .0001).
  
  
  CONCLUSIONS
  CT cholangiography accurately depicts biliary tract anatomy in living donor candidates for right hepatic lobe transplantation, and donors who undergo preoperative CT cholangiography are unlikely to need conventional intraoperative cholangiography.
authors.affiliation: Department of Radiology, University of California San Francisco, Box 0628, C-324C, 505 Parnassus Ave, San Francisco, CA 94143-0628, USA.
authors.forename: Zhen J
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Yeh
authors.forename: John P
authors.initials: JP
authors.lastname: Roberts
authors.forename: Richard S
authors.initials: RS
authors.lastname: Breiman
authors.forename: Aliya
authors.initials: A
authors.lastname: Qayyum
authors.forename: Fergus V
authors.initials: FV
authors.lastname: Coakley
mesh_terms: D000293:Adolescent; D000328:Adult; D001659:Biliary Tract / Q000000981:diagnostic imaging*; D002758:Cholangiography / Q000379:methods*; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed