Preoperative volume calculation of the hepatic venous draining areas with multi-detector row CT in adult living donor liver transplantation: Impact on surgical procedure.
OBJECTIVE
The purpose was to assess the volumes of the different hepatic territories and especially the drainage of the right paramedian sector in adult living donor liver transplantation (ALDLT).


METHODS
CT was performed in 40 potential donors of whom 28 underwent partial living donation. Data sets of all potential donors were postprocessed using dedicated software for segmentation, volumetric analysis and visualization of liver territories. During an initial period, volumes and shapes of liver parts were calculated based on the individual portal venous perfusion areas. After partial hepatic congestion occurring in three grafts, drainage territories with special regard to MHV tributaries from the right paramedian sector, and the IRHV were calculated additionally. Results were visualized three-dimensionally and compared to the intraoperative findings.


RESULTS
Calculated graft volumes based on hepatic venous drainage and graft weights correlated significantly (r = 0.86, P < 0.001). Mean virtual graft volume was 930 ml and drained as follows: RHV: 680 ml, IRHV: 170 ml (n = 11); segment 5 MHV tributaries: 100 ml (n = 16); segment 8 MHV tributaries: 110 ml (n = 20). When present, the mean aberrant venous drainage fraction of the right liver lobe was 28%.


CONCLUSIONS
The evaluated protocol allowed a reliable calculation of the hepatic venous draining areas and led to a change in the hepatic venous reconstruction strategy at our institution.
Frericks
Bernd B J
BB
Department of Radiology, Hanover Medical School, 30625 Hannover, Germany. bernd.frericks@charite.de
Kirchhoff
Timm D
TD
Shin
Hoen-Oh
HO
Stamm
Georg
G
Merkesdal
Sonja
S
Abe
Takehiko
T
Schenk
Andrea
A
Peitgen
Heinz-Otto
HO
Klempnauer
Jürgen
J
Galanski
Michael
M
Nashan
Bjoern
B
D000328:Adult; D005260:Female; D006498:Hepatectomy; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed