Presurgical evaluation of the liver transplant candidate.

Determination of liver transplant candidacy requires an integrated approach contingent upon clinical, surgical, and radiologic evaluation. Imaging patients with end-stage liver disease is a challenging yet fascinating task. Chest radiographs, ultrasound with Doppler, and unenhanced and biphasic contrast CT provide sufficient preoperative information about the majority of patients. Problematic cases, however, may require a multimodality approach, for which chest CT, invasive abdominal CT techniques, MR imaging, cholangiography, angiography, and biopsy have all been useful adjuncts. In addition to providing important information for surgical planning, the radiologist must carefully look for any evidence of malignancy or other conditions that jeopardize successful OLTX and threaten meaningful postoperative survival.