Hemodynamic alterations in anterior segment of liver graft after right-lobe living-donor liver transplantation: Computed tomography perfusion imaging findings

Background: To identify hemodynamic alterations in anterior segment of liver graft after living-donor liver transplantation (LDLT) using CT perfusion imaging. Methods: Perfusion images of 19 recipients 4 weeks after LDLT without reconstruction of the middle hepatic vein (MHV) tributaries were retrospectively identified. According to major MHV tributaries diameter in the right lobe graft, recipients were divided into large (≥;5 mm) and small size groups (<5 mm). Blood flow (BF), blood volume (BV), and mean transit time (MTT) of anterior and posterior segments were calculated. Results: In large size group, significantly decreased BF (66.98 ± 15.79 mL/min/100 g, corresponded to 37.08%), BV (8.27 ± 2.29 mL/100 g, 41.71%), and increased MTT (11.79 ± 2.10 s, 23.71%) were detected in the anterior segment compared to the posterior segment. In small size group, compared to the posterior segment, BF, BV in the anterior segment decreased 19.12%, 18.48%, respectively, and MTT increased 6.78%, where decreased BF (86.40 ± 21.39 mL/min/100 g) and BV (11.50 ± 2.59 mL/min/100 g) reached statistical significance. Perfusion imbalance in large size group was more remarkable than those in small size group. Conclusions: CT liver perfusion imaging enabled quantification of hemodynamic alterations in right-lobe liver graft after LDLT. Compared to small ones, ligation of large MHV tributaries could bring about more marked perfusion imbalance between anterior and posterior segments.