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MR images of small, nodular
liver with cirrhosis

Courtesy of Hitachi

MR may hold the key to evaluating living liver donors

by Lauren Dubinsky , Senior Reporter
MR techniques may be able to replace the invasive, time-consuming conventional methods for evaluating living liver donors, according to a review published this month in the American Journal of Roentgenology.

With the introduction of cross-sectional imaging techniques, CT and MR have started to take the place of catheter digital subtraction anglography, endoscopic retrograde cholangio-pancreatography and liver biopsy. The benefit of MR over CT is that it doesn’t expose the patient to ionizing radiation.

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New developments in contrast agents and pulse sequences have significantly improved MR image quality by overcoming time and spatial resolution limitations. The review authors noted that the gadolinium-based contrast agents used with MR are generally safe with allergic reactions being rare.

Liver transplantation is the most effective treatment for many patients with end-stage liver disease and irreversible hepatic failure. But the high demand has caused a relative shortage of cadaveric organs, so the industry is now turning to living-donor liver transplants.

Because of the organ shortage, more than 6,000 patients die in the U.S. each year — over 1,400 of these deaths are those waiting on a liver transplant, according to the American Transplant Foundation. However in 2015, 359 liver transplants were made possible by living donors.

During living liver donor surgery, the donor and the recipient are placed in adjacent operating rooms. The surgeon removes a part of the donor’s liver, which is immediately placed in the recipient.

The remaining part of the donor’s liver is sufficient to maintain normal body functions and the recipient is given a large enough portion of the donor liver to also maintain body functions. Over the next couple of months, both livers grow to normal size.

“To guide safe harvesting of the graft from donors, an accurate preoperative evaluation of potential living liver donors for conditions that increase the donor's surgical risk is crucial," Dr. Kartik S. Jhaveri, of the Joint Department of Medical Imaging at the University of Toronto, said in a statement.

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