Magnetic resonance cholangiography in living donor liver transplantation.

Abstract:

OBJECTIVE:Exact knowledge of biliary anatomy is essential in living donor liver transplantation. The purpose of this study was to evaluate the accuracy of pretransplant magnetic resonance cholangiography (MRC) in depicting the biliary anatomy in comparison with intraoperative cholangiography (IOC). MATERIALS AND METHODS:From May 2006 to July 2009, 451 potential living liver donors underwent pretransplant evaluation at the Chang Gung Memorial Hospital-Kaohsiung Medical Center. Two hundred thirty-three donors underwent donor hepatectomy. Of these, only 203 donors with both preoperative MRC and IOC were included in this study. RESULTS:Of the 451 potential donors, 218 (48.3%) were considered unsuitable for liver donation, hence was immediately disqualified after the initial evaluation for various reasons. Six of the 218 unsuitable donors (2.8%) were excluded due to complicated biliary anatomy. The overall accuracy rate of MRC for defining the biliary anatomy was 91.6%, with 84.9% sensitivity, 96% specificity, 88.2% positive predictive value, and 94.7% negative predictive value. There were 14 misidentified cases. The errors in MRC reading was largely attributed to the poor contrast between the biliary ducts and the surrounding tissues and organs. The concurrence between MRC and IOC were commendable (κ=0.9). No significant biliary complications were noted in the mismatch group. CONCLUSION:MRC is essential for all pretransplantation evaluation with 91.6% accuracy rate.

journal_name

Transplantation

journal_title

Transplantation

authors

Hsu HW,Tsang LL,Yap A,Huang TL,Chen TY,Lin TS,Concejero AM,Ou SY,Yu CY,Chen CL,Cheng YF

doi

10.1097/TP.0b013e31821c1e33

subject

Has Abstract

pub_date

2011-07-15 00:00:00

pages

94-9

issue

1

eissn

0041-1337

issn

1534-6080

journal_volume

92

pub_type

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