Pre-hepatic and pre-pancreatic transplant donor evaluation

The first successful solid organ transplant in humans was performed by Harrison and Murray in 1954, between two identical twins (1). Subsequent work on immunosuppression in the three decades after 1950 revolutionized the area of transplantation, facilitating the work of Starzl when he completed the first successful liver transplant (LT) in 1967 (2-5). In association with improvements in organ preservation and extended donor eligibility, organ transplantation has become an increasingly important and successful component of modern medicine with more than 34,000 transplants performed in the United States alone in 2017 (6). Imaging plays a critical role in organ transplantation as it allows assessment of donors and recipients both before and after transplantation. The growing use of living candidates to meet the demand for organ donors has resulted in frequent imaging of donors during pre-transplantation assessment. These requests are not restricted solely to tertiary transplant centers given the increasing development of regional and national transplant networks. Identification of donor anatomy, variants and any associated pathology is essential for the selection of appropriate surgical candidates and suitable surgical technique. This process has been facilitated by the improved multimodality protocols and techniques available to radiologists. Detailed knowledge and understanding of these options and protocols is critical to ensuring optimal patient outcomes, and ultimately survival. This article will focus on imaging evaluation of donor candidates for liver and pancreas transplantation