Imaging in the preoperative evaluation of adult liver-transplant candidates: goals, merits of various procedures, and recommendations.

Advances in organ procurement and surgical techniques have made orthotopic liver transplantation (OLT) an accepted treatment for many adult patients with end-stage hepatic disease. At present, OLT is being performed in patients with a variety of diseases, and 5-year survival is estimated at 65-78% [1]. Over 80% of hepatic transplants are performed in patients with cirrhosis or primary cholestatic liver disease, and only 5% of transplants are performed for malignant hepatic neoplasms (Table 1) [2]. Because the supply of donor organs is limited, preoperative clinical and radiologic evaluation of the transplant candidate is critical for appropriate patient selection. The main objective of preoperative imaging is to provide the surgeon with the pertinent information needed to plan and perform OLT and to exclude patients for whom surgery either is not feasible or will be of no benefit.