title: Persistence of portosystemic collaterals and splenomegaly on CT after orthotopic liver transplantation.
abstract: OBJECTIVE
  The appearances of portosystemic collaterals and splenomegaly on CT before and after liver transplantation were evaluated.
  
  
  METHODS
  The records of 54 patients undergoing liver transplantation during a 2.5-year period were reviewed retrospectively. Twenty-five of these patients, in whom both a preoperative abdominal CT scan and a follow-up CT scan at least 1 year after transplantation had been obtained, were clinically well and had had no significant episodes of rejection, severe recurrent hepatitis, or other complication at the time of study. A total of 94 abdominal CT scans in these patients were reviewed to assess changes in portosystemic collaterals and splenic volume.
  
  
  RESULTS
  At 6 months after transplantation, portosystemic collaterals at one or more sites were seen in 14 (74%) of the 19 patients scanned at this time in whom collaterals had been seen on CT preoperatively. At 1 year after transplantation, splenic hilar collaterals persisted in 64% of patients, splenocolic ligament collaterals in 50%, retroperitoneal collaterals in 38%, and peripancreatic collaterals in 38% of patients with preoperative varices at these sites who were examined with CT at this interval. Splenic hilar, coronary, and retroperitoneal collaterals were found to persist for up to 4 years after transplantation in the single patient examined at that time. Splenic volume decreased in 94% of patients examined after transplantation, with a mean reduction of 60 +/- 19%. However, the spleen remained significantly enlarged in 56% of patients.
  
  
  CONCLUSIONS
  We conclude that portosystemic collaterals and splenomegaly frequently persist after liver transplantation, but that this finding need not indicate recurrence of hepatic disease or other posttransplantation complications.
authors.affiliation: Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322.
authors.forename: J L
authors.initials: JL
authors.lastname: Chezmar
authors.forename: R D
authors.initials: RD
authors.lastname: Redvanly
authors.forename: R C
authors.initials: RC
authors.lastname: Nelson
authors.forename: J M
authors.initials: JM
authors.lastname: Henderson
mesh_terms: D000328:Adult; D003097:Collateral Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011172:Portography; D012189:Retrospective Studies; D013163:Splenomegaly / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed