Skip to main content
Top
Published in: Abdominal Radiology 10/2018

01-10-2018

Living donor liver transplantation: post-operative imaging follow-up of right lobe liver donors

Authors: Tapas K. Tejura, Alejandro Pita, Christian Romero, Yuri S. Genyk, Linda Sher, Suzanne L. Palmer

Published in: Abdominal Radiology | Issue 10/2018

Login to get access

Abstract

Purpose

To identify long-term post-operative imaging findings resulting from right lobe liver donation.

Methods

This retrospective imaging review consisted of 42 adults (20 males, 22 females, mean age 36.6 years, range 18.7–55.9 years) who underwent right lobe liver donation with pre- and post-operative imaging between 1999 and 2006. The mean follow-up period was 30.2 months (range 12.3–69.6 months). Follow-up imaging evaluation included assessment of the biliary tree, particularly isolated bile ducts draining to and terminating at the cut surface (orphan ducts). Three-dimensional volumetry of the liver remnant was also assessed.

Results

After liver donation, 29/42 (69%) participants demonstrated orphan ducts on follow-up imaging (95% confidence interval 52.9% to 82.4%). In those patients with orphan ducts, the main draining ducts were normal in 70% and dilated in 69%. Nearly all right lobe liver donors with orphan ducts had no clinical symptoms on follow-up (28/29); the only liver donor with clinical symptoms on follow-up was subsequently diagnosed with primary biliary cirrhosis. Mean regenerated liver volume was approximately 93%, with mean pre-operative total liver volume of 1552 ml (median 1504 ml, range 1040–2520 ml) and mean post-operative total liver volume of 1446 ml (median 1455 ml, range 964–2090 ml).

Conclusions

Orphan ducts are changes that may be seen after liver donation. The presence of these findings in the absence of clinical symptoms or abnormal hepatic chemistries does not require further work-up and should not be considered pathologic.
Literature
4.
go back to reference Broelsch CE, Emond JC, Whitington PF, et al. (1990) Application of reduced-size liver transplants as split grafts, auxiliary orthotopic grafts, and living related segmental transplants. Ann Surg 212(3):368–375CrossRefPubMedPubMedCentral Broelsch CE, Emond JC, Whitington PF, et al. (1990) Application of reduced-size liver transplants as split grafts, auxiliary orthotopic grafts, and living related segmental transplants. Ann Surg 212(3):368–375CrossRefPubMedPubMedCentral
5.
go back to reference Yamaoka Y, Wahhida M, Honda K, et al. (1994) Liver transplantation using a right lobegraft from a living related donor. Transplantation 57:1127–1130CrossRefPubMed Yamaoka Y, Wahhida M, Honda K, et al. (1994) Liver transplantation using a right lobegraft from a living related donor. Transplantation 57:1127–1130CrossRefPubMed
6.
go back to reference Muzaale AD, Dagher NN, Montgomery RA, et al. (2012) Estimates of early death, acute liver failure, and long-term mortality among live liver donors. Gastroenterology 142:273–280CrossRefPubMed Muzaale AD, Dagher NN, Montgomery RA, et al. (2012) Estimates of early death, acute liver failure, and long-term mortality among live liver donors. Gastroenterology 142:273–280CrossRefPubMed
7.
go back to reference Dew MA, Butt Z, Humar A, Dimartini AF (2017) Long-term medical and psychosocial outcomes in living liver donors. Am J Transplant 17(4):880–892CrossRefPubMed Dew MA, Butt Z, Humar A, Dimartini AF (2017) Long-term medical and psychosocial outcomes in living liver donors. Am J Transplant 17(4):880–892CrossRefPubMed
8.
go back to reference Abecassis MM, Fisher RA, Olthoff KM, et al. (2012) Complications of living donor hepatic lobectomy—a comprehensive report. Am J Transplant 12:1208–1217CrossRefPubMedPubMedCentral Abecassis MM, Fisher RA, Olthoff KM, et al. (2012) Complications of living donor hepatic lobectomy—a comprehensive report. Am J Transplant 12:1208–1217CrossRefPubMedPubMedCentral
9.
go back to reference Adcock L, Macleod C, Dubay D, et al. (2010) Adult living liver donors have excellent long-term medical outcomes: The University of Toronto liver transplant experience. Am J Transplant 10:364–371CrossRefPubMed Adcock L, Macleod C, Dubay D, et al. (2010) Adult living liver donors have excellent long-term medical outcomes: The University of Toronto liver transplant experience. Am J Transplant 10:364–371CrossRefPubMed
10.
go back to reference Miller CM, Durand F, Heimbach JK, et al. (2016) The international liver transplant society guideline on living liver donation. Transplantation 100(6):1238–1243CrossRefPubMed Miller CM, Durand F, Heimbach JK, et al. (2016) The international liver transplant society guideline on living liver donation. Transplantation 100(6):1238–1243CrossRefPubMed
11.
go back to reference Palmer S, Tumyan L, Huan E, et al. (2008) Living donor liver transplantation: post-operative imaging follow-up of 54 right lobe donors with clinical correlation [abstract]. In: Americas Hepato-Pancreato-Biliary Association Annual Meeting, Fort Lauderdale, FL, 26–30 Mar 2008 Palmer S, Tumyan L, Huan E, et al. (2008) Living donor liver transplantation: post-operative imaging follow-up of 54 right lobe donors with clinical correlation [abstract]. In: Americas Hepato-Pancreato-Biliary Association Annual Meeting, Fort Lauderdale, FL, 26–30 Mar 2008
12.
go back to reference Liddell RM, Baron RL, Ekstrom JE, Varnell RM, Shuman WP (1990) Normal intrahepatic bile ducts: CT depiction. Radiology 176(3):633–635CrossRefPubMed Liddell RM, Baron RL, Ekstrom JE, Varnell RM, Shuman WP (1990) Normal intrahepatic bile ducts: CT depiction. Radiology 176(3):633–635CrossRefPubMed
13.
go back to reference Couinaud C (1980) Definition of hepatic anatomical regions and their value during hepatectomy. Chirurgie 106:103–108PubMed Couinaud C (1980) Definition of hepatic anatomical regions and their value during hepatectomy. Chirurgie 106:103–108PubMed
14.
go back to reference Healey JE, Schroy PC (1953) Anatomy of the biliary ducts within the human liver. Arch Surg 66:599–616CrossRef Healey JE, Schroy PC (1953) Anatomy of the biliary ducts within the human liver. Arch Surg 66:599–616CrossRef
15.
16.
go back to reference Wachs ME, Bak TE, Karrer FM, et al. (1998) Adult living donor liver transplantation using the right lobe. Transplantation 66:1313–1316CrossRefPubMed Wachs ME, Bak TE, Karrer FM, et al. (1998) Adult living donor liver transplantation using the right lobe. Transplantation 66:1313–1316CrossRefPubMed
17.
go back to reference Zappa M, Dondero F, Sibert A, et al. (2009) Liver regeneration at day 7 after right hepatectomy: global and segmental volumetric analysis by using CT. Radiology 252:426–432CrossRefPubMed Zappa M, Dondero F, Sibert A, et al. (2009) Liver regeneration at day 7 after right hepatectomy: global and segmental volumetric analysis by using CT. Radiology 252:426–432CrossRefPubMed
18.
go back to reference Maetani Y, Itoh K, Egawa H, et al. (2003) Factors influencing liver regeneration following living-donor liver transplantation of the right hepatic lobe. Transplantation 75:97–102CrossRefPubMed Maetani Y, Itoh K, Egawa H, et al. (2003) Factors influencing liver regeneration following living-donor liver transplantation of the right hepatic lobe. Transplantation 75:97–102CrossRefPubMed
19.
go back to reference Klink T, Simon P, Knopp C, et al. (2014) Liver remnant regeneration in donors after living donor liver transplantation: Long-term follow-up using CT and MR imaging. Fortschr Röntgenstr 186:598–605 Klink T, Simon P, Knopp C, et al. (2014) Liver remnant regeneration in donors after living donor liver transplantation: Long-term follow-up using CT and MR imaging. Fortschr Röntgenstr 186:598–605
20.
go back to reference Murad SD, Fidler JL, Poterucha JJ, et al. (2016) Longterm clinical and radiological follow-up of living liver donors. Liver Transpl 22:934–942CrossRef Murad SD, Fidler JL, Poterucha JJ, et al. (2016) Longterm clinical and radiological follow-up of living liver donors. Liver Transpl 22:934–942CrossRef
21.
go back to reference Karlo C, Reiner CS, Stolzmann P, et al. (2010) CT- and MRI-based volumetry of resected liver specimen: comparison to intraoperative volume and weight measurements and calculation of conversion factors. Eur J Radiol 75:e107–e111CrossRefPubMed Karlo C, Reiner CS, Stolzmann P, et al. (2010) CT- and MRI-based volumetry of resected liver specimen: comparison to intraoperative volume and weight measurements and calculation of conversion factors. Eur J Radiol 75:e107–e111CrossRefPubMed
Metadata
Title
Living donor liver transplantation: post-operative imaging follow-up of right lobe liver donors
Authors
Tapas K. Tejura
Alejandro Pita
Christian Romero
Yuri S. Genyk
Linda Sher
Suzanne L. Palmer
Publication date
01-10-2018
Publisher
Springer US
Published in
Abdominal Radiology / Issue 10/2018
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-018-1512-5

Other articles of this Issue 10/2018

Abdominal Radiology 10/2018 Go to the issue

Classics in Abdominal Imaging

The cluster sign

Classics in Abdominal Radiology

The Champagne sign

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.