Abstract
Background/aim Vascular complications can be detected in liver transplant patients. Digital subtraction angiography has served as the gold standard to make this diagnosis; however, due to its invasive nature, ultrasonography is used for the preliminary evaluation. The purpose of this study was to evaluate the role of multislice computerized tomography angiography (MSCTA) in the detection of vascular complications of symptomatic and asymptomatic liver transplant patients and to compare the results with Doppler ultrasound (Doppler US) findings. Materials and methods Fifty-three liver transplant patients (6 symptomatic, 47 asymptomatic) underwent Doppler US examination followed by an MSCTA. The findings in each modality were interpreted in a blinded fashion and then compared. Results MSCTA detected 15 abnormalities, none of which were detected by Doppler US. There were hepatic and splenic artery aneurysms (n = 4) and various stenoses (n = 4), infrarenal aortic anastomosis (n = 4), vena cava inferior thrombosis (n = 1), arteriovenous malformation (n = 1), and esophageal varices (n = 1). Conclusion MSCTA detected more lesions and we believe that it should be considered as a road map for Doppler US follow-ups as well as a routine screening modality for early detection of vascular complications in symptomatic and asymptomatic liver transplantation patients that may be missed by Doppler US.
Highlights
Human whole-liver transplantation as a therapeutic option for end-stage liver disease was pioneered in 1963 by Starzl et al [1]
Materials and methods: Fifty-three liver transplant patients (6 symptomatic, 47 asymptomatic) underwent Doppler US examination followed by an multislice computerized tomography angiography (MSCTA)
MSCTA detected 15 abnormalities, none of which were detected by Doppler US
Summary
Human whole-liver transplantation as a therapeutic option for end-stage liver disease was pioneered in 1963 by Starzl et al [1]. Liver transplantation has emerged as the best therapeutic choice for selected irreversible liver failure patients almost 50 years ago [2]. Initial efforts were unsuccessful, today, following years of modification of surgical techniques and the introduction of new immunosuppressive agents, liver transplantation is an accepted and successful therapy for end-stage liver failure. Vascular complications, including hepatic artery stenosis and thrombosis, can be detected in liver transplant patients. Digital subtraction angiography (DSA) has served as the gold standard to make this diagnosis, due to its invasive nature, ultrasonography is used for the preliminary evaluation. Three-dimensional helical computed tomographic arteriography (3D CTA) with maximum intensity
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