Effective dose for multiple and repeated radiation examinations in donors and recipients of adult-to-adult living donor liver transplants at a single center. Issue 129 (August 2020)

• Record Type: Journal Article
• Authors: Chiang, Hsien-Wen; Chuang, Tzu-Chao; Chen, Chao-Long; Tyan, Yeu-Sheng; Lin, Ting-Lung; Tsang, Leo Leung-Chit; Tu, Jou-An; Chou, Ying-Hsiang; Tsai, Hui-Yu; Chen, Tou-Rong
• Is Part Of: European journal of radiology. Issue 129(2020)
• Publication Date: 2020-08
• Subjects: LDLT living donor liver transplantation -- CT computed tomography -- NM nuclear medicine -- DDLT deceased donor liver transplants -- KCGMH Kaohsiung Chang Gung Memorial Hospital -- PA posterior anterior -- AP anterior posterior -- DLP dose–length product -- IOC intraoperative cholangiography -- HCC hepatocellular carcinoma -- HBV hepatitis B virus -- HCV hepatitis C virus -- CA & 3-p chest to abdomen with non-contrast phase, liver arterial phase, portal venous phase, and delayed phase -- Liver 4-p liver non-contrast phase, liver arterial phase, portal venous phase, and delayed phase; Effective dose -- Liver transplant -- Living -- Donor -- Recipient; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2020.109078
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Both donors and recipients received substantial effective dose, mainly from CT examinations. The potential threat of radiation dose to patient health cannot be ignored in LDLT. Recipients with HCC received a higher effective dose than those with other indications. Abstract: Purpose: To evaluate the effective doses received by donors and recipients, identify effective dose contributions, and make risk assessments. Materials and Methods: It was a retrospective study. 100 Donors and 100 recipients were enrolled with an operative day from March 2016 to August 2017. The dose was analyzed for all radiation-related examinations over a period of 2 years, 1 year before and 1 year after the LDLT procedure. The effective doses of plain X-rays, CT, fluoroscopy, and nuclear medicine per patient were simulated by a Monte Carlo software, evaluated by the dose-length product conversion factors, evaluated by the dose-area product conversion factors, and evaluated by the activity conversion factors, respectively. The risks of radiation-induced cancer were assessed on the basis of the ICRP risk model. Results: The median effective doses were 71 (range: 30–186) mSv for donors and 147 (32–423) mSv for recipients. The radiation examinations were mainly performed in the last three months of preoperative period to first month of postoperative period for recipients and donors. The HCC recipients received a higher effective dose, 195 (64–423) mSv, than those with other indications. The median radiation-induced cancer risk was 0.38 % in male and 0.48 % in female donors and was 0.50 % in male and 0.58 % in female recipients. Conclusion: Donors and recipients received a large effective dose, mainly from the CT scans. To reduce effective doses should be included in future challenges in some living donor liver transplants centers that often use CT examinations.