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Clinical Trial
. 2006 Sep 28;12(36):5820-5.
doi: 10.3748/wjg.v12.i36.5820.

Adult-to-adult right lobe living donor liver transplantation: comparison of endoscopic retrograde cholangiography with standard T2-weighted magnetic resonance cholangiography for evaluation of donor biliary anatomy

Perdita Wietzke-Braun  1 , Felix Braun, Dieter Muller, Thomas Lorf, Burckhardt Ringe, Giuliano Ramadori
Affiliations
Clinical Trial

Adult-to-adult right lobe living donor liver transplantation: comparison of endoscopic retrograde cholangiography with standard T2-weighted magnetic resonance cholangiography for evaluation of donor biliary anatomy

Perdita Wietzke-Braun et al. World J Gastroenterol. .

Abstract

Aim: To compare the value of endoscopic retrograde cholangiography (ERC) and standard T2-weighted magnetic resonance cholangiography (MRC) in the evaluation process as adult-to-adult right lobe living donor liver transplantation (LDLTx) demands a successful outcome, and exact knowledge of the biliary tree is implicated to avoid biliary complications, postoperatively.

Methods: After starting the LDLTx program, 18 liver transplant candidates were selected for LDLTx by a stepwise evaluation process. ERC and standard T2-weighted MRC were performed to evaluate the biliary system of the donor liver. The anatomical findings of ERC and MRC mapping were compared using the Ohkubo classification.

Results: ERC allowed mapping of the whole biliary system in 15/15 (100%) cases, including 14/15 (93.3%) with biliary variants while routine MRC was only accurate in 2/13 (15.4%) cases. MRC was limited in depicting the biliary system proximal of the hepatic bifurcation. Postoperative biliary complications occurred in 2 donors and 8 recipients. Biliary complications were associated with Ohkubo type C, E or G in 6/8 recipients, and 2/3 recipients with biliary leak received a graft with multiple (>=2) bile ducts.

Conclusion: Pretransplant ERC is safe and superior over standard MRC for detection of biliary variations that occur with a high frequency. However, precise knowledge of biliary variants did not reduce the incidence of postoperative biliary complications.

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Figures

Figure 1
Figure 1
Preoperative MRC and ERC of donor No.11 with RHD. A: MRC, doubled; B: ERC, two separate.
Figure 2
Figure 2
Preoperative MRC and ERC of donor No.14 with RHD. A: MRC, suspicion of early division; B: ERC, trifurcation of RHD to SV, VI, and VIII.
Figure 3
Figure 3
Preoperative MRC and ERC of donor No.8. A: MRC, no variation; B: ERC, SVII drains into LHD, SIVa drains into RHD.
See this image and copyright information in PMC

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