CT angiographic evaluation of portal vein variations in liver transplant donors

CT Angiographic Evaluation of Portal Vein Variations in Liver Transplant Donors Liver transplantation is one of the most important advances in treatment of patients with liver failure. Preoperative knowledge of portal vein variations is essential during transplantation surgery for both donor and recipient survival. The purpose of this study is to determine the prevalence of portal vein variations and which variations are encountered more commonly in patients applying to our institution for liver transplantation from live donor by retrospectively evaluating their preoperative hepatic computed tomography angiographies (CTA). In the study, 100 liver donors who were to undergo liver transplantation and had preoperative liver CTAs taken in Akdeniz University Hospital Department of Radiology between July 2014-December 2015 were included. Portal venous system variations were classified as follows: Main portal vein dividing into left portal vein (LPV) and right portal vein (RPV), following which RPV branches into right anterior and right posterior branches (Type I), trifurcation of main portal vein to left, right anterior and right posterior portal veins (Type II), main portal vein dividing into right posterior branch and a common trunk giving rise to the LPV and right anterior branch (type III). Besides these, RPV variations of origin of segment 6 branch separate from RPV, origin of segment 7 branch separate from RPV, origin of both segment 6 and 7 branches separate from RPV, RPV trifurcation or quadrification were also evaluated. Out of 100 patients, 80 (80,0%) had type I; 8 (8,0%) had type II and 12 (12,0%) had type III portal vein. Out of 80 patients with type I portal vein, there were 9 (11,25%) with RPV variations: 1 (1,25%) RPV quadrification; 3 (8,75%) RPV trifurcation; 1 (1,25%) origin of segment 6 branch separate from RPV; 3 (3,75%) origin of segment 7 branch separate from RPV; 1 (1,25%) origin of both segment 6 and 7 branches separate from RPV. There was no statistically significant difference with respect to age or sex among portal vein variations. 49 CTA is an established imaging modality to evaluate portal vein variations prior to surgery. Preoperative knowledge of portal vein variations before liver transplantation from live donor is essential to determine the correct surgical approach and reduce complications.