A multimodality approach of the main complications after liver transplantation: tips for the radiologists

Congress:

ECR 2020

Poster Number:

C-10485

Type:

Educational Exhibit

Keywords:

Not applicable, Transplantation, Grafts, Cirrhosis, Diagnostic procedure, Complications, Ultrasound-Colour Doppler, MR, CT, Liver, Abdomen, Abdominal Viscera

Authors:

A. I. Gomes¹, E. E. Dutenhefner², A. Talans², R. S. O. D. P. Furtado², R. H. Baroni²; ¹Sao Paulo, Sao Paulo/BR, ²São Paulo/BR

DOI:

10.26044/ecr2020/C-10485

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-10485

Fig. 1: Hepatic artery stenosis. Male patient, 62 years old, performed liver...

Fig. 2: Hepatic artery thrombosis. Male patient, 55-year-old, performed liver...

Fig. 3: Hepatic artery and right portal branch thrombosis + parenchymal ischemia...

Fig. 4: Hepatic artery aneurysm. Male patient, 55 years old, chronic liver disease by...

Fig. 11: Biliary cast. Male patient, 45 years old, performed liver transplantation for...

Fig. 5: Aneurysmal portal vein tromboses. Male patient, 70 years old, performed liver...

Learning objectives

The present study proposes a review of the main complications after liver transplantation according to the structure affected and time after surgery, bringing together some specific Doppler ultrasound features and cross-sectional imaging studies in order to guide their diagnosis.

Background

The first-line treatment for chronic liver disease and end-stage acute disorders is liver transplantation. But postoperative complications are relatively frequent and may limit the long-term success of the graft. Arterial and venous thrombosis and stenosis, pseudoaneurysm, biliary disorders, fluid collections, neoplasms and graft rejections are the most common and clinically significant complications. Imaging plays an important role in early diagnosis and consequently the successful management of all these complications, except graft rejection. A multimodality approach including Doppler ultrasound and cross-sectional imaging studies is the most...

Findings and procedure details

Complications after liver transplantation can be classified in vascular, biliary and others, which include: infection, abscess, hematoma, neoplasm, cirrhosis and bowel perforation. We used several illustrative cases from our Ultrasound and Abdominal Imaging groups in order to demonstrate the main complications after liver transplantation in different imaging modalities, including: Hepatic artery stenosis; Portal vein thrombosis; Hepatic artery thrombosis; Inferior vena cava thrombosis of the donor; Inferior vena cava stenosis; Biliary cast; Chronic transplant ischemia; Hepatic artery aneurysm; Acute peripheral ischemia; Biliary fistula; Choledocholithiasis; Cholangitis; Biloma;...

Conclusion

Imaging plays an essential role in the diagnosis of liver transplantation complications. Doppler ultrasound is the method of choice for initial evaluation and follow-up after surgery, but a multimodality approach is often recommended to determine the locationand type of complication. Therefore, radiologists should be familiar with the main complications and the applicability of each modality in order to guide the diagnostic approach and the proper management.

Personal information and conflict of interest

A. I. Gomes; Sao Paulo, SAO PAULO/BR - nothing to disclose E. E. Dutenhefner; Sao Paulo, SAO PAULO/BR - nothing to disclose A. Talans; São Paulo/BR - nothing to disclose R. S. O. D. P. Furtado; sao paulo, SAO PAULO/BR - nothing to disclose R. Baroni; Sao Paulo/BR - nothing to disclose

References

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