Preoperative imaging in adult-to-adult living related liver transplant donors - What surgeons want to know

Because of an overwhelming demand for cadaveric livers in the United States that far outstrips supply, living related liver transplantation is increasingly being performed to help treat a cohort of patients with severe end-stage liver disease. This procedure demands careful preoperative evaluation to minimize morbidity to the healthy donor and recipient, however. As a part of the workup, radiologic assessment of the donor hepatic vascular and biliary anatomy, hepatic volume, and hepatic parenchyma (with regard to focal and diffuse liver disease) is essential. In this pictorial essay, the experience of a group of investigators at the University of California at Los Angeles is reviewed, and the essential radiologic components of the preoperative evaluation of hepatic vascular and biliary anatomy, hepatic parenchyma, and lobar volume are described. The roles of high-field magnetic resonance (MR) imaging, MR angiography, MR cholangiopancreatography, multidetector-row computed tomography (CT) angiography, and CT cholangiography in the workup are discussed.