[Diagnostic imaging after liver transplantation].
BACKGROUND
Orthotopic liver transplantation (OLT) has become an accepted treatment for end-stage liver disease. However, postoperative complications result in significant patient morbidity and mortality. Early detection and treatment of these complications is therefore of utmost importance.


METHODS
We retrospectively reviewed the postoperative complications of the patients who underwent OLT at our institution. Duplex Doppler sonography and cholangiography were the primary imaging modalities in postoperative evaluation of the transplanted liver. Other important techniques were CT, MRI and angiography, which may contribute to a reliable diagnosis of vascular or biliary complications.


RESULTS
Second to primary organ dysfunction, vascular complications are the most frequent cause of graft loss. Thrombosis of the hepatic artery is the most common and most serious vascular complication, with a reported incidence from 4 to 42%. Bile duct sludge, leaks and strictures are frequent complications after liver transplantation, which can contribute to graft dysfunction. Biliary tract complications usually occur within the first 3 months and require interventional radiological or surgical therapy. Since liver transplant recipients undergo immunosuppressive therapy, they are at increased risk of developing late post-transplant malignancies, which are best depicted by US, CT or MRI. However, radiological diagnosis of lympho-proliferative disorder has to be confirmed by liver biopsy.


CONCLUSIONS
Cholangiography and Duplex sonography are routinely used in the postoperative evaluation of patients with OLT. CT, MRI, and angiography are problem-solving tools in equivocal cases.
Turetschek
K
K
Abteilung für konservative Fächer, Universitätsklinik für Radiodiagnostik, Wien.
Schima
W
W
Stift
A
A
Schober
E
E
Dock
W
W
Mostbeck
G
G
D003952:Diagnostic Imaging; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D017093:Liver Failure / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000401:mortality; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D015996:Survival Rate