Imaging plays an important role in intra and post operative period of the transplant.Routine Ultrasound dopplers are performed upto Day 5 twice to detect immediate and early post operative complications if any.
Further if the USG /doppler indicate any abnormality CECT is performed for further evaluation.
MRI plays a role predominantly in the late complications,
especially Biliary.MRCP is a non-invasive imaging method which can evaluate the biliary system beyond a tight stricture in addition to assessment of the hepatic parenchyma and other intra-abdominal viscera.
This exhibit predominantly focuses on the CT/MRI findings in patients with post transplant complications.
The patients underwent Triple phase CT on 128 slice CT scanner and 3T MRI.
Commonly seen self resoving post operative imaging findings include pleural effusion,
ascites,peri hepatic haematoma and periportal edema.
Vascular complications of inflow include thrombosis,
stenosis of the hepatic artery or the portal vein.Pseudoaneurysm arising from the hepatic artery due to intimal injury is a rare complication seen in 0.3-1.3% of patients.
Outflow complications inclde Hepatic veins or IVC thrombosis /stenosis and kinking.These are less common and seen in upto 3% of patients.Secondary Budd chiari changes develop in the hepatic parenchyma in long standing cases.
Biliary complications include bile leak,bilioma, bile duct calculi,bile duct necrosis,
cholangitis and strictures.
Miscellaneous like haematoma,abscess,infection,hepatitis,
portal hypertension,splenic infarct,
recurrent malignancy(HCC),drug associated encephalopathy and post transplant lympho proliferative disorder.
Drug associated encephalopathy(Tacrolimus) is reversible and requires close monitoring of the serum drug levels.