Transplantation proceedings · 2013
Perfusion defects detected after liver transplantation on multidetector computerized tomography: short- and long-term follow-up.
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Shin Y C, Choi C S, Kim J S
Аннотация
BACKGROUND: Perfusion defects are sometimes found during the follow-up computerized tomography (CT) after liver transplantation (OLT). This study sought to determine the short- and long-term outcomes of perfusion defects observed after OLT with the use of multidetector CT.
METHODS: From February 4, 2004, to December 8, 2011, a total 46 LTs were performed in our hospital owing to end-stage liver cirrhosis (n = 43), liver cirrhosis with hepatocellular carcinoma (HCC; n = 1), combined HCC with cholangiocellular carcinoma (CCC; n = 1), or hepatic failure from acute hepatitis A (n = 1). The transplanted livers were procured from cadaveric (n = 24) or living related donors (n = 22). The average age of the recipient was 53.3 ± 10.4 years. The male-female ratio was 30:16. Postoperative multidetector CT was performed with a dynamic sequence in 203 examinations and with a portal phase in 46 examinations. The contrast media was Radisense. The rate of injection of 120 mL was 3 mL/s with a power injector; the iodine concentration was 300 or 370 mg/dL. Follow-up ranged from 3 months 3 days to 7 years 363 days. We classified perfusion defects as chronic segmental or subsegmental benign ischemia, transient focal perfusion defects, benign subcapsular ischemia, or fatal whole liver perfusion defects.
RESULTS: There were 3 cases of chronic segmental or subsegmental benign ischemia, 8 focal transient perfusion defects, 1 benign subcapsular ischemia, and 4 fatal whole liver perfusion defects. Except the fatal cases, all other perfusion defects occurred in the courses of benign conditions without resection or reoperation.
CONCLUSIONS: Most perfusion defects were benign and uneventful, requiring no treatment, with the exception of fatal whole liver perfusion defects, which resulted in death after detection.
METHODS: From February 4, 2004, to December 8, 2011, a total 46 LTs were performed in our hospital owing to end-stage liver cirrhosis (n = 43), liver cirrhosis with hepatocellular carcinoma (HCC; n = 1), combined HCC with cholangiocellular carcinoma (CCC; n = 1), or hepatic failure from acute hepatitis A (n = 1). The transplanted livers were procured from cadaveric (n = 24) or living related donors (n = 22). The average age of the recipient was 53.3 ± 10.4 years. The male-female ratio was 30:16. Postoperative multidetector CT was performed with a dynamic sequence in 203 examinations and with a portal phase in 46 examinations. The contrast media was Radisense. The rate of injection of 120 mL was 3 mL/s with a power injector; the iodine concentration was 300 or 370 mg/dL. Follow-up ranged from 3 months 3 days to 7 years 363 days. We classified perfusion defects as chronic segmental or subsegmental benign ischemia, transient focal perfusion defects, benign subcapsular ischemia, or fatal whole liver perfusion defects.
RESULTS: There were 3 cases of chronic segmental or subsegmental benign ischemia, 8 focal transient perfusion defects, 1 benign subcapsular ischemia, and 4 fatal whole liver perfusion defects. Except the fatal cases, all other perfusion defects occurred in the courses of benign conditions without resection or reoperation.
CONCLUSIONS: Most perfusion defects were benign and uneventful, requiring no treatment, with the exception of fatal whole liver perfusion defects, which resulted in death after detection.