Paraumbilical collateral veins on MRI as possible protection against portal venous thrombosis in candidates for liver transplantation

Verma, Sachit K.; Mitchell, Donald G.; Lakhman, Yulia; Bergin, Diane; Dolin, Ronald J.; Doria, Cataldo; Parker, Laurence

doi:10.1007/s00261-007-9333-y

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…Gadolinium is a contrast media that clarifies hyper and hypovascular lesions and has been used for identification of some diseases (19–21). Our data suggest that MRI is useful for assessment of ischemic / necrotic / apoptotic areas of the liver after islet transplantation and we suggest that gadolinium enhancement could be applied not only for assessment of islet vascularization (12), but also for detection of liver ischemia due to islet embolization as liver perfusion defects.…”

Section: Discussionmentioning

confidence: 99%

MRI Assessment of Ischemic Liver After Intraportal Islet Transplantation

et al. 2009

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Background There is a recent focus on embolization of the portal vein by transplanted islets as a major cause of early graft loss. The resultant ischemia causes necrosis and/or apoptosis of cells within the liver. Thus, non-invasive assessment of the liver receiving the islet transplant is important to evaluate the status islet grafts. Methods In this study, we utilized non-invasive magnetic resonance imaging (MRI) for assessment of the post-transplant ischemic liver. Syngeneic islets in streprozotocin-induced diabetic mice were utilized. MRI and morphological liver assessments were performed at 0, 2, and 28 days after transplantation. Histological assessment of insulin, hypoxia induced factor 1-α and apoptosis were undertaken at similar time-points. Results Ischemic/necrotic regions in the liver were detected with MRI at 2 but not at 28 days after transplantation and were confirmed histologically. Liver injury was quantified from high intensity areas on T2-weighted images. Insulin release showed a peak 2 days after transplantation. Conclusion Onset and reversal of liver ischemia due to intraportal islet transplantation are detectable using T2-weighted MRI. These changes coincide with periods of maximum insulin release likely due to partial islet destruction. We propose that MRI, as a noninvasive monitor of graft-related ischemia, may be useful in assessment of liver and islet engraftment after intraportal islet transplantation in a clinical setting.

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Section: Discussionmentioning

confidence: 99%

MRI Assessment of Ischemic Liver After Intraportal Islet Transplantation

et al. 2009

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Epidemiology of portal vein thrombosis in liver cirrhosis: A systematic review and meta-analysis

Pan¹,

Wang²,

Gao³

et al. 2022

European Journal of Internal Medicine

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Large Paraumbilical Vein Shunts Increase the Risk of Overt Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Placement

Tang

Zhang

Zhao

et al. 2022

JCM

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Background: This study aimed to evaluate whether a large paraumbilical vein (L-PUV) was independently associated with the occurrence of overt hepatic encephalopathy (OHE) after the implantation of a transjugular intrahepatic portosystemic shunt (TIPS). Methods: This bi-center retrospective study included patients with cirrhotic variceal bleeding treated with a TIPS between December 2015 and June 2021. An L-PUV was defined in line with the following criteria: cross-sectional areas > 83 square millimeters, diameter ≥ 8 mm, or greater than half of the diameter of the main portal vein. The primary outcome was the 2-year OHE rate, and secondary outcomes included the 2-year mortality, all-cause rebleeding rate, and shunt dysfunction rate. Results: After 1:2 propensity score matching, a total of 27 patients with an L-PUV and 54 patients without any SPSS (control group) were included. Patients with an L-PUV had significantly higher 2-year OHE rates compared with the control group (51.9% vs. 25.9%, HR = 2.301, 95%CI 1.094–4.839, p = 0.028) and similar rates of 2-year mortality (14.8% vs. 11.1%, HR = 1.497, 95%CI 0.422–5.314, p = 0.532), as well as variceal rebleeding (11.1% vs. 13.0%, HR = 0.860, 95%CI 0.222–3.327, p = 0.827). Liver function parameters were similar in both groups during the follow-up, with a tendency toward higher shunt patency in the L-PUV group (p = 0.067). Multivariate analysis indicated that having an L-PUV (HR = 2.127, 95%CI 1.050–4.682, p = 0.037) was the only independent risk factor for the incidence of 2-year OHE. Conclusions: Having an L-PUV was associated with an increased risk of OHE after a TIPS. Prophylaxis management should be considered during clinical management.

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Paraumbilical collateral veins on MRI as possible protection against portal venous thrombosis in candidates for liver transplantation

Cited by 3 publications

References 33 publications

MRI Assessment of Ischemic Liver After Intraportal Islet Transplantation

MRI Assessment of Ischemic Liver After Intraportal Islet Transplantation

Epidemiology of portal vein thrombosis in liver cirrhosis: A systematic review and meta-analysis

Large Paraumbilical Vein Shunts Increase the Risk of Overt Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Placement

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