The objective of this pictorial essay is to describe and illustrate the role of imaging in detecting early and late complications after pediatric liver transplantation (LT) and their possible percutaneous treatments using a case series collected in our institution (Radiology Unit - Department of Medicine - University Hospital of Padova).
Liver transplantation (LT) represents the treatment of choice in end-stage liver disease; the main indications [1,
cholestatic diseases: biliary atresia (about 46% of all pediatric LTs),
metabolic diseases: maple syrup urine disease,
liver tumors: hepatoblastoma,
acute liver failure (very rare in children).
Surgical techniques [1,
whole-LT: performed as in adults,
with classic (inferior vena cava replacement) or piggyback (preservation of the native inferior vena cava) technique;
Findings and procedure details
Imaging modalities [2,
- US/DopplerUS is the first imaging modality for the evaluation of liver graft dysfunction in vascular as well as in biliary complications;
- MR is a problem solving modality,
especially thanks to its angiographic and cholangiographic sequences and the lack of ionizing radiations;
- CT is the imaging technique of choice in emergency,
it can also be used as a guide to percutaneous aspiration and fluid collection drainage;
- interventional radiology techniques allow the detection and treatment of vascular and...
Complications are frequent after pediatric LT .
Biliary complications are the most frequent,
while vascular complications are the most dangerous for graft survival .
The early detection of post-operative complications allows their prompt treatment,
avoiding graft failure and improving patient survival [1,
Different imaging modalities help in the detection of early and late complications of LT,
as well as in long-term follow-up to assess transplant viability [1,
Interventional radiology has an increasing role in the management of postoperative complications .
Annachiara Cavaliere,MD,Radiology resident
Silvia Karem Janet Flores Quispe, MD,Radiology resident
Veronica De Lorenzo,
Radiology Uniti - Departement of Medicine - University of Padova
2 - 35128,
Padova - Italy
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