Magnetic resonance cholangiography in living donor liver transplantation

Hsien Wen Hsu, Leo Leung Chit Tsang, Anthony Yap, Tung Liang Huang, Tai Yi Chen, Tsan Shiun Lin, Allan M. Concejero, Shin You Ou, Chun Yen Yu, Chao Long Chen, Yu Fan Cheng*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

19 Scopus citations

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.

Original languageEnglish
Pages (from-to)94-99
Number of pages6
JournalTransplantation
Volume92
Issue number1
DOIs
StatePublished - 15 07 2011

Keywords

  • Intraoperative cholangiography
  • Living donor liver transplantation
  • Magnetic resonance cholangiography

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