Hepatic Venous Congestion After Right-lobe Living-donor Liver Transplantation

Abstract

To describe and determine the additional value of delayed-phase imaging of hepatic venous congestion after living-donor liver transplantation. Twenty-eight patients who had surgical ligation of the middle hepatic vein (HV) in living-donor liver transplantation underwent 3-phase computed tomography scans. Two radiologists analyzed in consensus the presence and pattern of the hepatic attenuation difference and the opacification of the HV in the congested areas of the liver during each phase of the initial and follow-up computed tomography scanning. The imaging findings were correlated with the serum bilirubin level. Opacification of the HV was observed more frequently in 22 (92%) of 24 hyperattenuating areas on delayed-phase (DP) scans than in 2 (50%) of 4 hypoattenuating areas in the congested areas of the liver. Patients with persistent hypoattenuatation in the congested areas on all phases (14%) showed significantly persistent hyperbilirubinemia after postoperative 4 weeks and showed a higher mortality rate (50%) than did the other patients with hyperattenuation on DP scans. A hypoattenuating area of the liver during DP scans indicates severe hepatic congestion and is correlated with hyperbilirubinemia and a high mortality rate.