Learning objectives
● Explain the findings of vascular complications in patients with liver transplantation.
● Illustrate these findings by images of patients in our institution.
Background
Currently,
liver transplantation is the first line treatment for patients with terminal liver disease,
both acute and chronic. However,
postoperative complications may limit the success of the intervention and increase mortality and morbidity of patients.
Clinical manifestations of complications of liver transplantation are so unspecific.
That’s why medical imaging (especially Doppler ultrasound) are more and more important.
It is therefore essential that the radiologist knows the most common complications and their presentation on imaging techniques.
Findings and procedure details
Imaging techniques used in our center are:
● Postoperative Doppler ultrasound at 24-48 h,
day 7,
first and third month.
● Trans-Kehr cholangiography on days 7 and 90.
● More ultrasound examinations,
CT or angiography are made based on the findings on the first ultrasound examination or in case of impaired liver function.
Vascular complications appear early so the Doppler study in the early days should be thorough. They can affect hepatic artery,
portal vein or hepatic veins.
In this paper the complications of each...
Conclusion
● Early detection of vascular complications of liver transplantation,
for effective treatment is needed.
This determines the effectiveness of transplantation and patient mortality and morbidity.
● Doppler ultrasound is the initial imaging test.
● If do not allow definitive diagnosis,
other techniques (ultrasound contrast,
CT,
MRI) are needed.
References
1.- Bhargava P,
Vaidya S,
Dick A,
Dighe M.
Imaging of Orthotopic Liver Transplantation: Review.
American Journal of Roentgenology 2011;196:WS15–25.
doi:10.2214/AJR.09.7221.
2.- Caiado A,
Blasbalg R,
Marcelino A,
da Cunha Pinho M,
Chammas M,
da Costa Leite C,
et al.
Complications of Liver Transplantation: Multimodality Imaging Approach.
RadioGraphics 2007;27:1401–17.
doi:10.1148/rg.275065129.
3.- Singh A,
Nachiappan A,
Verma H,
Uppot R,
Blake M,
Saini S,
et al.
Postoperative Imaging in Liver Transplantation: What Radiologists Should Know.
RadioGraphics 2010;30:339–51.
doi:10.1148/rg.302095124.