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
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 effective diagnostic approach to guide us toward a correct diagnosis since clinical signs of complications are often nonspecific.
Ultrasound (US) is considered the first imaging modality for postoperative follow-up because of its low-cost, accessibility, non-invasive method and can be performed at bedside. However, there are some limitations such as gas interposition, obesity and technical experience.
Cross-sectional imaging studies such as computed tomography (CT) and magnetic resonance imaging (MRI) are more sensitive and specific than US but require patient’s mobilization, many of them in critical clinical conditions.
Angiography is the gold-standard method for detection of vascular complications after liver transplantation and represents an important option for nonsurgical treatment.