Original Research Article
Year: 2023 | Month: January | Volume: 13 | Issue: 1 | Pages: 126-132
DOI: https://doi.org/10.52403/ijhsr.20230118
MDCT Angiography in The Assessment of Vascular Variants in Potential Liver Donors
Kavin M1, Nazar P K2
1,2Department of Radiology, Amrita institute of medical sciences and research centre, Kochi, India
Corresponding Author: Kavin M
ABSTRACT
BACKGROUND: Liver transplantation is currently considered as a definitive therapeutic option for managing patients with chronic liver disease. Due to the considerably greater complexity of LDLT surgical technique, safe harvesting and successful transplantation necessitate cautious donor selection and preoperative mapping of the vascular anatomy. The aim of this study was to evaluate the vascular variations in potential living liver donors and to assess the association between the vascular variance with intra operative and post operative complications.
METHODS: Study population included 87 cases potential living liver donors selected from June 2020 to June 2022. Prior to liver transplant, each donor underwent MDCT angiography of the abdomen. Recipients were then monitored intraoperatively and postoperatively for up to six months to determine the presence or absence of various problems in grafts with normal arterial anatomy vs those with variable arterial morphology.
RESULTS: A total of 56 cases (64.4%) had standard type I arterial anatomy and 31 cases (35.6%) had variance in artery. The Michels’ type III anatomy is the most prevalent variation (13.8%) of cases, followed by type II arterial anatomy (11.5%). Standard type I portal vein anatomy was seen in 70 cases (80%). A total of 19 people (22%) had accessory right hepatic vein (RHV) and 28 cases (32%) had inferior hepatic vein (IHV). Results of grafts with standard anatomy were compared with grafts with variant anatomy. We found no statistically significant association found between vascular variations with intra operative and post complications.
CONCLUSION: Nearly two-third of prospective liver donors had variant in any of vascular supply. Most prevalent variations involves hepatic arterial anatomy which was found in 35.6% patients. Michels’ type III arterial anatomy was found to be the most common variation followed by Michels’ type II. With regard to the portal vein anatomy, type II portal vein anatomy was found to be the most common variation. We found no statistical significant association between the grafts with variant vascular anatomy with intraoperative and postoperative complications.
Key words: Living donor liver transplantation (LDLT), multi detector computed tomography (MDCT), right hepatic vein (RHV), inferior hepatic vein (IHV), right hepatic artery (RHA).