Analysis of the hepatic vessels structure in potential liver donors

Aim. To analyze anatomic variants of arterial and venous blood supply of liver in potential liver donors by using of CT-angiography (CTA).

Material and methods. CTA data of 151 potential donors have been examined for the period 01.01.2016-01.01.2018. Non-ionic iodine-containing (320 mg/ml) contrast agent was used at a dose of 1.4 ml/kg and infusion rate near 4.0 ml/s. Variants of arterial anatomy were classified according to N. Michels, portal vein anatomy — according to T Nakamura classification (2002).

Results. N. Michels type I was the most common variant of arterial structure (n = 108, 71.5%). Types II and III were observed in 8.6% and in 7.9% of cases, respectively. Types IV and IX included the same number of donors (2.6%). Types VII and VIII were the rarest (0.7% and 1.3%). Types V, VI, X were absent. There were 7 cases (4.6%) with arterial variants which are not described by N.Michels classification. Moreover, 3 types were not previously described by other authors.

Conclusion. Hepatic artery variations coincide with the classification of N. Michels as a rule (95.4%). Other anatomic variants not described in this classification were observed only in 4.6% of cases.

1. Gautier S.V., Konstantinov B.A., Tsirulnikova O.M. Trans-plantacijapecheni. [Liver transplantation]. Medical news agency. 2008. 246 p. (In Russian)

2. Pannu H.K., Maley W.R., Fishman E.K. Liver transplantation: preoperative CT evaluation. Mping the hepatic surgeon. 2001; Suppl (1): 133-146. DOI: 10.1148/radiographics.21.suppl_1.g01oc03s133.

3. Michels N.A. Blood supply and anatomy of the upper abdominal organs with a descriptive atlas. Philadelphia: JB Lippincott Co., 1955: 359-367.

4. Michels N.A. Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J. Surg. 1966; 112 (9): 337-347.

5. Nakamura T., Tanaka K., Kiuchi T., Kasahara M., Oike F., Ueda M., Kaihara S., Egawa H., Ozden I., Kobayashi N., Uemoto S. Anatomical variations and surgical strategies in right lobe living donor liver transplantation: lessons from 120 cases. Transplant. 2002; 73 (12): 1896-1903.

6. Coskun M., Kayahan E.M., Ozbek O., Cakir B., Dalgif A., Haberal M. Imaging of hepatic arterial anatomy for depicting vascular variations in living related liver transplant donor candidates with multidetector computed tomography: comparison with conventional angiography. Transplant. Proc. 2005; 37 (2): 1070-1073. DOI: 10.1016/j.transproceed.2005.01.019.

7. Borisova E.L. Anatomic variations of the hepatic arteries in 200 patients. Rossijskij jelektronnyj zhurnal luchevoj diagnostiki. 2013; 3 (3): 84. (In Russian)

8. Galyan T.N. Angioarhitektonika i biliarnaja anatomija pecheni rodstvennogo donora po dannym mul'tispiral'noj kompjuternoj i magnitno-rezonansnoj tomografii [Angioarchitectonics and biliary anatomy of related donor liver according to computed tomography and magnetic resonance imaging: avtoref. diss. . cand. med. sci.]. Moscow, 2011. P. 9-10. (In Russian)

9. Gruttadauria S., Foglieni C.S., Doria C., Luca A., Lauro A., Marino I.R. The hepatic artery inliver transplantation and surgery: Vascular anomalies in 701 cases. Clin. Transplant. 2001; 15 (5): 359-363.

10. Abramova N.N., Muslimov R.Sh., Uvarov K.A. Multispiral computed tomography in donor survey for liver fragment transplantation from living related donor. Vestnik transplantologii i iskusstvennyh organov. 2009; 9 (3): 39-41. (In Russian)

11. Gulyaev V.A., Dubinin S.A., Andreytseva O.I., Chugunov A.O., Lutsyk K.N., Novruzbekov M.S., Juravel S.V., Jagraev K.R., Zhao A.V. Arterial blood supply of liver regarding its transplantation. Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 2001; 6 (2): 47-53. (In Russian)

12. Belous P.V. Variant anatomy of liver arterial and ductal system. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta. 2014; 3: 117-122. (In Russian)

13. Balakhnin P.V. Znachenie variantov arterial'noj anatomiipecheni dlja vypolnenija intervencionno-radiologicheskih vmeshatel'stv [The significance of variants of liver arterial anatomy for interventional procedures: avtoref. diss. ... cand. med. sci.]. St. Petersburg, 2012: 7-11. (In Russian)

14. Bhardwaj N. Anomalous origins of hepatic artery and its significance for hepatobiliary surgery. J. Anat. Soc. India. 2010; 59 (2): 173-176.

15. Catalano O.A., Singh A.H., Uppot R.N., Hahn P.F., Ferrone C.R., Sahani D.V. Vascular and biliary variants in the liver: Implications for liver surgery. Radiographics. 2008; 28 (2): 359-378. DOI: 10.1148/rg.282075099.

16. Merion R.M., Burtch G.D., Ham J.M., Turcotte J.G., Campbell D.A. The hepatic artery in liver transplantation. Transplant. 1989; 48 (3): 438-443.

17. Starostina N.S. MSKT angiografiya dlya vyyavleniya aberrantnykh arterii i kollateralei tseliako-mezenterialnogo basseina do i posle operatsii na podzheludochnoi zheleze s rezektsiei magistral'nykh arterii bez ikh rekonstruktsii [CT-angiography for occupying aberrant arteries and collaterals of celiac and mesenteric arteries before and after pancreatic surgery followed by great vessels resection without their reconstruction: diss. ... cand. med. sci.]. Moscow, 2015. 51 p. (In Russian)

18. Hennedige T., Anil G., Madhavan R. Expectations from imaging for pre-transplant evaluation of living donor liver transplantation. World J. Radiol. 2014; 6 (9): 693-707.

19. Vohra S., Goyal N., Gupta S. Preoperative CT evaluation of potential donors in living donor liver transplantation. Indian J. Radiol. Imaging. 2014; 24 (4): 350-359. DOI: 10.4103/0971-3026.143897.