|ECR 2018 / C-0650|
|Pre-liver transplantation workup; what should the radiologist look for.|
Liver transplantation is considered the only curative treatment for patients with end stage liver disease (1) and a successful treatment for unresectable small hepatocellular carcinoma (HCC) (2). Its outcome had greatly improved during the last years giving the advance of immunosuppressive treatments and surgical techniques (1).
The majority of transplanted livers are from cadaveric donors (3) while the remaining are from living donors who undergo partial hepatectomy for liver donation (left lateral segment or right lobe for pediatric or adult recipients respectively) (1).
Successful liver transplantation requires a multidisciplinary approach with careful pre-procedural preparation as well as long term follow up. Radiologists play a crucial role in the pre-procedural workup and the short/long term follow up. Therefore, understanding the surgical procedure and its potential complications is essential for an adequate radiological assessment (4).
Preoperative evaluation of liver parenchyma, its vascularization and biliary system in both donors and recipients can be performed using magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound (US) imaging with Doppler evaluation (4).
In our institution, when there is no contraindication, contrast-enhanced MR imaging and MR Cholangiopancreatography (MRCP) are the first choice for preoperative evaluation, given the fact that these imaging techniques are radiation free, ensure accurate parenchymal analysis as well as adequate evaluation of vasculature and biliary system (1).