UW MEDICINE ULTRASOUND

Liver Living Donor

LIVING LIVER DONOR PROTOCOL

(UABDD)

Patient Prep:  NPO for 4-6 hours.

 

Diagram:

Diagram Liver Donor

 

Protocol:

Do the ABDOMEN DOPPLER PROTOCOL with additional documentation listed below.

Additional documentation specific for living donor ultrasound exams:

Left Hepatic Vein Documentation (subcostal view)

  1.  Document origin of the middle and left hepatic vein in XS (2D and color Doppler).
  2. Measure the Left hepatic vein (inner to inner just like a yolk sac) just before it enters the IVC
  3. Cine-clip documentation (slow sweep please) in B-mode and color Doppler XS from superior to inferior (ROI color box should include almost the entire left lobe of the liver).
    • Look for collaterals or connection between the branches of the left and middle hepatic vein – finding cross-over vein(s) that are (≥5mm) before confluence of LHV-MHV are critical for the pre-surgery work-up.
    • If a collateral vein is found please document with color Doppler and 2D and measure the vein in the greatest diameter.

 

 hepaticveins

 

 hepaticvenousvariants

Left portal vein documentation

  1. Measure the diameter of the left portal vein at the origin (small arrow).
  2. Measure the length of the left portal vein from bifurcation until it branches (thick arrow).

 

portalveinsmeas

 Main portal vein documentation

  1. Measure the main portal vein diameter at the porta hepatis (small double arrow).
  2. Measure the length of the main portal vein up to the bifurcation (origin of the first branch) (thicker double arrow).
  3. 2D cine clip scanning through the main portal vein (oblique long axis view of the main portal vein) medial to the origin of the left portal vein.

portalveinsmeas2