Assessment of Hepatic Arterial Anatomy Prior to Organ Recovery


Iatrogenic hepatic arterial injury during organ recovery increases ischaemic times and risk of hepatic artery thrombosis. A review of CT imaging prior to organ recovery would alert retrieving surgeons to the presence of anatomical variants. This study aimed to identify the proportion of donors with coincidental CT scans for review and the ability of organ retrieval surgeons to interpret these images. Consecutive organ donors with coincidental abdominal contrast enhanced CT scans were assessed by review of an electronic radiology database. These images, with additional cases, were blindly reviewed by organ recovery surgeons to assess their ability to define anatomy. 13/156 donors had coincidental imaging for review. Using 23 CT sequences, the median positive and negative predictive value of surgeons to correctly describe right hepatic arterial anatomy was 0.83 and 0.94, of the left hepatic anatomy was 0.75 and 0.94 respectively. The availability of CT imaging for review prior to donation is low. However, when available, surgeons can correctly define hepatic arterial anatomy in the majority of cases. A practice of routinely reviewing available imaging prior to organ recovery would be expected to decrease iatrogenic arterial injury.

Share and Cite:

Roberts, K. , Malde, D. , Adams, B. , Hodson, J. , Sheridan, M. and Hidalgo, E. (2012) Assessment of Hepatic Arterial Anatomy Prior to Organ Recovery. Open Journal of Organ Transplant Surgery, 2, 28-31. doi: 10.4236/ojots.2012.24008.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] J. R. Hiatt, J. Gabbay and R. W. Busuttil, “Surgical Anatomy of the Hepatic Arteries in 1000 Cases,” Annals of Surgery, Vol. 220, No. 1, 1994, pp. 50-52. doi:10.1097/00000658-199407000-00008
[2] L. M. Marin-Gomez, M. A. Gomez-Bravo, C. Bernal-Bellido, J. M. Alamo-Martinez, G. Suarez-Artacho, et al., “Variability of the Extrahepatic Arterial Anatomy in 500 Hepatic Grafts,” Transplantation Proceedings, Vol. 42, No. 8, 2010, pp. 3159-3161. doi:10.1016/j.transproceed.2010.05.078
[3] D. M. Nijkamp, M. J. Slooff, C. S. van der Hilst, A. J. Ijtsma, K. P. de Jong, et al., “Surgical Injuries of Postmortem Donor Livers: Incidence and Impact on Outcome after Adult Liver Transplantation,” Liver Transplantation, Vol. 12, No. 9, 2006, pp. 1365-1370. doi:10.1002/lt.20809
[4] T. Soliman, F. Langer, H. Puhalla, H. Pokorny, T. Grunberger, et al., “Parenchymal Liver Injury in Orthotopic Liver Transplantation,” Transplantation, Vol. 69, No. 10, 2000, pp. 2079-2084. doi:10.1097/00007890-200005270-00018
[5] S. J. Wigmore, F. M. Seeney, H. C. Pleass, R. K. Praseedom and J. L. Forsythe, “Kidney Damage during Organ Retrieval: Data from UK National Transplant Database. Kidney Advisory Group,” Lancet, Vol. 354, No. 9185, 1999, pp. 1143-1146. doi:10.1016/S0140-6736(98)09409-4
[6] N. A. Michels, “Newer Anatomy of the Liver and Its Variant Blood Supply and Collateral Circulation,” The American Journal of Surgery, Vol. 112, No. 3, 1966, pp. 337-347. doi:10.1016/0002-9610(66)90201-7
[7] J. P. Duffy, J. C. Hong, D. G. Farmer, R. M. Ghobrial, H. Yersiz, et al., “Vascular Complications of Orthotopic Liver Transplantation: Experience in More Than 4200 Patients,” Journal of the American College Surgeons, Vol. 208, No. 5, 2009, pp. 896-903. doi:10.1016/j.jamcollsurg.2008.12.032
[8] A. Fregeville, C. De Bazelaire, A. Zagdanski, M. Albiter, F. Desgrandchamps, et al., “Value of Whole Body CTA in the Management of Brain-Dead Patients,” Journal of Radiology, Vol. 91, No.1, 2010, pp. 37-44.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.