Robb Caroline L, Fowler Kathryn J, Bierhals Andrew J, Raptis Demetrios A, Majella Doyle Maria B, Chapman William C, Raptis Constantine A
From the Department of Radiology, Mallinckrodt Institute of Radiology (Robb, Bierhals, D Raptis, C Raptis), Washington University in St Louis School of Medicine, St Louis, MO.
Department of Radiology, University of California-San Diego, San Diego, CA (Fowler).
J Am Coll Surg. 2022 Feb 1;234(2):166-175. doi: 10.1097/XCS.0000000000000042.
Computed tomography (CT) is routinely used to determine the suitability of potential living donor liver transplants, providing important information about liver size, vascular anatomy, and the presence of other diseases that would preclude it from safe donation. CT is not routinely used, however, when evaluating eligible deceased organ donors after brain death, a group which comprises most orthotopic liver transplants. After the installation of a CT scanner at a local procurement facility, CTs have been performed on potential deceased organ donors and used, in conjunction with other evaluative protocols, to help direct donation decisions and assist in procurement procedures.
A retrospective analysis of data from 373 cases spanning 5 years was systematically collected and analyzed, including information pertaining to patient's medical histories, biopsy results, operative findings, and CT results.
CT findings directly impacted the directive decision-making process in 29% of cases in this patient cohort, likely an underestimate, and reliably evaluated important factors including variant vascular anatomy and the presence and severity of hepatic steatosis and cirrhosis.
Overall, this study suggests that CT has the potential to play a significant role in procurement procedures and the directive decision-making process, thereby improving the efficiency and accuracy by which potential deceased organ donors are evaluated.
计算机断层扫描（CT）通常用于确定潜在活体供肝移植的适用性，提供有关肝脏大小、血管解剖结构以及其他可能妨碍安全捐献的疾病的重要信息。然而，在评估脑死亡后符合条件的已故器官捐献者时，CT并不常用，而这类捐献者是大多数原位肝移植的来源。在当地一个获取机构安装CT扫描仪后，已对潜在的已故器官捐献者进行了CT扫描，并结合其他评估方案，用于指导捐献决策和协助获取程序。
系统收集并分析了跨越5年的373例病例的数据，包括与患者病史、活检结果、手术发现和CT结果相关的信息。
在该患者队列中，CT结果直接影响了29%的病例的指导性决策过程，这可能是一个低估，并且CT能够可靠地评估重要因素，包括变异的血管解剖结构以及肝脂肪变性和肝硬化的存在及严重程度。
总体而言，本研究表明CT在获取程序和指导性决策过程中有可能发挥重要作用，从而提高评估潜在已故器官捐献者的效率和准确性。
