Role of imaging in pre-hepatic transplantation evaluation

Abstract

Infectious diseases of the liver are major causal factors leading to acute or chronic liver failure and end-stage liver failure necessitating Liver transplantation (LT). Parasitic infections (Alveolar echinococcosis) and viral hepatitis (HBV and HCV) in particular are prominent infectious diseases in China which carry substantial morbidity rate. Chronic infections of HBV and HCV have a high potential to develop Hepatocellular cancer (HCC). At the end stage or acute liver failure due to these infectious diseases, LT places itself as an effective treatment option. It is a complex procedure requiring the collaborative planning of a radiologist, transplant surgeon, oncologist, and hepatologist. The criteria required for liver transplantation are constantly being optimized with an aim of decreasing the risks involved and increasing the post-transplant survival rate. Role of imaging is crucial in differentiating the normal from abnormal anatomy of the liver, anatomical variants of the vasculature and biliary tree. It helps the transplant surgeon in deciding the technique which benefits both the donor and recipient, putting the graft to optimal use. In this article, we review the literature on infectious diseases (viral and parasitic) of the liver, their impact on the necessity to undergo hepatic transplantation while highlighting the role of imaging evaluation during pre-transplantation stage.