Detection of Vascular Complications After Liver Transplantation

Katyal, Sikandar L.; Oliver, James H.; Buck, David G.; Federle, Michael P.

doi:10.2214/ajr.175.6.1751735

Cited by 82 publications

(22 citation statements)

References 8 publications

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“…Hepatic artery stenosis and thrombosis are the most common vascular complications after OLT, 1,8,9 but early diagnosis may change their natural history, improving the chances of graft salvage and the patient's prognosis. 2,4 Unfortunately, the clinical features of a post-OLT hepatic artery stenosis or thrombosis are highly variable, are often nonspecific, and sometimes appear very late or are totally absent.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 Unfortunately, the clinical features of a post-OLT hepatic artery stenosis or thrombosis are highly variable, are often nonspecific, and sometimes appear very late or are totally absent. 1,5,10 Therefore, close monitoring of blood flow in the hepatic artery is fundamental in the follow-up of patients after liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Both complications can occur either early in the postoperative course or years after the OLT. Hepatectomy disrupts collateral arterial vessels, and the intrahepatic biliary epithelium of the transplanted liver is perfused only by the main hepatic artery, so the resulting decreased arterial perfusion produces biliary ischemia.…”

mentioning

confidence: 99%

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Doppler evaluation of arterial complications of adult orthotopic liver transplantation

Vit

Candia

Como

et al. 2003

J of Clinical Ultrasound

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The most accurate indicator of hepatic arterial stenosis or thrombosis was a change in the spectral waveform to a tardus-parvus pattern, with 91% sensitivity and 99.1% specificity. Among the other parameters, an increase of the SAT value (> 0.08 second), when associated with the morphologic modification of the systolic peak, is a more reliable parameter than the RI for early detection of artery stenosis, especially when the type of anastomosis is unknown.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Doppler evaluation of arterial complications of adult orthotopic liver transplantation

Vit

Candia

Como

et al. 2003

J of Clinical Ultrasound

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“…However, because of limited contrast resolution and relative inability to show the anastomotic site, CT correctly identifies the site of biliary obstruction in 10% of patients only [2,16] . The main role for CT is then to assess HAT [19] and/or detect intra-and extra-hepatic hypoattenuating collections when a suspicious biloma has gadolinium chelate contrast agent just before the acquisition of MRC in order to suppress overlapping fluid signal from the stomach and/or duodenum with paramagnetic effects on the T2 relaxation time [23] . However, because of the risk to mask the vaterian region of the common bile duct as a possible site of BC, the use of oral negative contrast agent is a matter of expertise and institutional preferences.…”

Section: Diagnostic Approach To Biliary Complicationsmentioning

confidence: 99%

Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT

Girometti

Cereser

Bazzocchi

et al. 2014

WJR

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Core tip:The review is focused on three main topics, in order to emphasize why magnetic resonance cholangiography (MRC) is the preferred imaging modality to noninvasively assess the biliary system after orthotopic liver transplantation. First, the authors describe the different techniques that can be used, namely conventional MRC and contrast-enhanced MRC. Second, exemplificative imaging findings are illustrated in order to show the diagnostic reliability of the technique. Third, the Authors discuss the state-of-the-art role for MRC in assessing biliary complications as emerging from updated literature review. INTRODUCTIONDespite improvements in organ preservation, surgical technique, immunosuppression and postoperative management, biliary complications (BC) still represent the "Achille's heel" of orthotopic liver transplantation (OLT),

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“…Другим информативным методом является мультиспираль ная компьютерная томография (МСКТ) с внутри венным контрастированием, которая позволяет определить выраженность, протяженность стеноза [17,18].…”

Section: Introductionunclassified

Correction of extrahepatic portal hypertension in pediatric patient after liver transplantation

Monakhov¹,

Миронков²,

Dzhanbekov³

et al. 2017

RJTAO

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1 ФГБУ «Федеральный научный центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России, Москва, Российская Федерация 2 Кафедра трансплантологии и искусственных органов ГБОУ ВПО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России, Москва, Российская Федерация Введение. Трансплантация печени -многокомпонентный, сложный вид оперативного лечения. У паци ентов, перенесших такое лечение, могут наблюдаться различные осложнения. Одним из таких ослож нений является нарушение портального кровотока на фоне стеноза воротной вены. Материалы и ме-тоды. Спустя 6 лет у ребенка после трансплантации фрагмента печени отмечалось прогрессирование признаков портальной гипертензии (варикозно расширенные вены пищевода (ВРВП) 3й ст., выраженная спленомегалия). Функция трансплантата оставалась удовлетворительной, однако по результатам допол нительного обследования диагностирован стеноз воротной вены. Результаты. В результате проведенной коррекции портального кровотока у пациента отмечена положительная динамика. По данным лабора торноинструментальных методов обследования функция трансплантата нормальная, отмечено восста новление адекватного кровотока по воротной вене (свыше 80 см/с), регрессия признаков портальной гипертензии. Выводы. Ультразвуковое дуплексное сканирование трансплантата в сочетании с МСКТ ангиографией позволяет своевременно и достоверно выявить стеноз воротной вены. Чрескожночрес печеночное стентирование воротной вены -малоинвазивный и высокоэффективный метод коррекции портальной гипертензии. Антиагрегантная терапия под контролем агрегации тромбоцитов является не обходимым условием для успешной функции стента. Introduction. Liver transplantation is a multicomponent and complex type of operative treatment. Patients undergoing such a treatment sometimes are getting various complications. One of these complications is a portal hypertension associated with portal vein stenosis. Materials and methods. In 6 years after the left lateral section transplantation from living donor in a pediatric patient the signs of portal hypertension were observed. Stenosis of the portal vein was revealed. Due to this fact percutaneous transhepatic correction of portal vein stenosis was per formed. Results. As a result of the correction of portal blood flow in the patient a positive trend was noted. Accor ding to the laboratory and instrumental methods of examination the graft had a normal function, portal blood flow was adequate. In order to control the stent patency Doppler ultrasound and MSCT of the abdominal cavity with intravenous bolus contrasting were performed. Due to these examinations the stent function was good, the rate of blood flow in the portal vein due to Doppler data has reached 80 cm/sec, and a decrease of the spleen size was noted.

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Detection of Vascular Complications After Liver Transplantation

Abstract: Our early results indicate that three-dimensional multislice CT angiography with volume rendering can reveal common and potentially lethal vascular complications in patients who have undergone liver transplantation.

Cited by 82 publications

References 8 publications

Doppler evaluation of arterial complications of adult orthotopic liver transplantation

Doppler evaluation of arterial complications of adult orthotopic liver transplantation

Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT

Correction of extrahepatic portal hypertension in pediatric patient after liver transplantation

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