Complications of Orthotopic Liver Transplantation: Spectrum of Findings with Helical CT

Quiroga, Sergi; Sebastià, M. C.; Margarit, C; Castells, L.; Boyé, Rosa; Álvarez-Castells, Agustí

doi:10.1148/radiographics.21.5.g01se061085

Cited by 149 publications

(92 citation statements)

References 42 publications

(89 reference statements)

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“…Recent studies have reported that 3-dimensional multislice CT angiography with volume rendering can reveal vascular complications in patients who have undergone liver transplantation. [21][22][23] Because conventional angiography is an invasive procedure and MDCT angiography always precedes conventional angiography in our practice, we propose that multislice CT angiography could be used as a standard reference for vascular complications after liver transplantation. Finally, distal intrahepatic arteries were not analyzed routinely in the present study, and further analysis of these sites may have led to the detection of cases of distal or lobar HAS.…”

Section: Discussionmentioning

confidence: 99%

Routine intraoperative Doppler sonography in the evaluation of complications after living‐related donor liver transplantation

Choi

Lee

et al. 2007

J of Clinical Ultrasound

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Section: Discussionmentioning

confidence: 99%

Routine intraoperative Doppler sonography in the evaluation of complications after living‐related donor liver transplantation

Choi

Lee

et al. 2007

J of Clinical Ultrasound

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“…1 Representation of the arterial, venous, and biliary anastomoses in a split-liver graft (segments IIeIII). rich vascularization of the Roux-en-Y jejunal loop) or from the splenic and gastroduodenal arteries eliminates the symptoms of thrombosis and delays the need for emergency retransplantation, and this justifies a longer period of patient monitoring [9,10].…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced ultrasound with SonoVue in the evaluation of postoperative complications in pediatric liver transplant recipients

Bonini

Pezzotta

Morzenti

et al. 2007

Journal of Ultrasound

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KEYWORDSSplit liver; Pediatric liver transplantation; Complications; Contrast-enhanced sonography.Abstract Purpose: To evaluate the utility of contrast-enhanced sonography in the study of pediatric liver transplant recipients and its potential impact in reducing the need for invasive diagnostic procedures. Materials and methods: From October 2002 to December 2003 we performed routine color Doppler ultrasound and contrast-enhanced ultrasound studies on 30 pediatric patients who had undergone liver transplantation. Findings indicative of complications were confirmed with invasive studies (angiography, computed tomography, and PTC). Results: Contrast-enhanced sonography correctly identified four of the five cases of hepatic artery thrombosis and all those involving the portal (n Z 6) and hepatic vein (n Z 3) thrombosis. It failed to identify one case of hepatic artery thrombosis characterized by collateral circulation arising from the phrenic artery and the single case of hepatic artery stenosis. The latter was more evident on color Doppler, which revealed a typical tardus parvus waveform. The use of contrast offered no significant advantages in the study of biliary complications although it did provide better visualization of bile leaks. Conclusions: Contrast-enhanced sonography improves diagnostic confidence and reduces the need for more invasive imaging studies in the postoperative follow-up of pediatric liver transplant recipients.Sommario Scopo: Valutare l'utilità dell'ecografia con mezzo di contrasto (Mdc) ecografico di II generazione nel paziente pediatrico trapiantato di fegato, in particolare al fine di ridurre il ricorso a metodiche diagnostiche invasive. ha fornito dati falsamente negativi in un caso di trombosi dell'arteria epatica, ricanalizzata da rami provenienti dall'arteria frenica, e nell'unico caso di stenosi anastomotica dell'arteria epatica della nostra casistica, nel quale è stato indicativo il pattern ''tardus parvus'' osservato all'esame eco-Doppler. Nel caso delle complicanze biliari l'esame eco-contrastografico non ha apportato significativi vantaggi, se non una migliore definizione dei margini e dell'estensione delle raccolte biliari post-intervento. Conclusioni: L'esame ecografico con Mdc è metodica in grado di incrementare la confidenza diagnostica dell'operatore, consentendo una riduzione al ricorso ad esami radiologici invasivi; ciò è particolarmente importante nel caso di pazienti a rischio, quali i bambini sottoposti a trapianto epatico. ª 2007 Published by Elsevier Masson.

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“…Other authors presume that acute occlusion may not result in a prompt dilatation of the prestenotic bile ducts [13][14][15] . It is reported, that helical CT, which is often used to examine suspected vascular disease, can also demonstrate associated biliary complications [17] , although exact data are not available. In our study, CT-scan was able to detect biliary congestion in 40% of AST and in 83% of ITBL with a specificity of 71%.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Biliary Strictures After Liver Transplantation: Which is the Best Tool?

&NA;

2005

Ultrasound Quarterly

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AIM:To evaluate the diagnostic value of different indirect methods like biochemical parameters, ultrasound (US) analysis, CT-scan and MRI/MRCP in comparison with endoscopic retrograde cholangiography (ERC), for diagnosis of biliary complications after liver transplantation. METHODS:In 75 patients after liver transplantation, who received ERC due to suspected biliary complications, the result of the cholangiography was compared to the results of indirect imaging methods performed prior to ERC. The cholangiography showed no biliary stenosis (NoST) in 25 patients, AST in 27 and ITBL in 23 patients. RESULTS:Biliary congestion as a result of AST was detected with a sensitivity of 68.4% in US analysis (specificity 91%), of 71% in MRI (specificity 25%) and of 40% in CT (specificity 57.1%). In ITBL, biliary congestion was detected with a sensitivity of 58.8% in the US, 88.9% in MRI and of 83.3% in CT. However, as anastomotic or ischemic stenoses were the underlying cause of biliary congestion, the sensitivity of detection was very low. In MRI detected the dominant stenosis at a correct localization in 22% and CT in 10%, while US failed completely. The biochemical parameters, showed no significant difference in bilirubin (median 5.7; 4,1; 2.5 mg/dL), alkaline phosphatase (median 360; 339; 527 U/L) or gamma glutamyl transferase (median 277; 220; 239 U/L) levels between NoST, AST and ITBL. CONCLUSION:Our data confirm that indirect imaging methods to date cannot replace direct cholangiography for diagnosis of post transplant biliary stenoses. However MRI may have the potential to complement or precede imaging by cholangiography. Optimized MRCP-processing might further improve the diagnostic impact of this method.

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Complications of Orthotopic Liver Transplantation: Spectrum of Findings with Helical CT

Cited by 149 publications

References 42 publications

Routine intraoperative Doppler sonography in the evaluation of complications after living‐related donor liver transplantation

Routine intraoperative Doppler sonography in the evaluation of complications after living‐related donor liver transplantation

Contrast-enhanced ultrasound with SonoVue in the evaluation of postoperative complications in pediatric liver transplant recipients

Diagnosis of Biliary Strictures After Liver Transplantation: Which is the Best Tool?

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