title: Multidetector computed tomography angiography in detection of active bleeding in renal and liver transplant recipients.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectivity of multidetector computed tomography angiography (MDCT-A) to detect active bleeding in transplant patients.
  
  
  METHODS
  Between 1999 and 2006, 532 patients underwent renal or liver transplantation. MDCT-A was performed on recipients who displayed decreased hemoglobin levels or who had a hematoma during abdominal ultrasound imaging. The MDCT-A used a 16-detector CT device (Siemens, Sensation) with slices 0.75 mm thick after injection of nonionic contrast media (4 mL per second). A multiple intensity projection (MIP) technique was used to maintain angiographic images in the axial and coronal planes.
  
  
  RESULTS
  MDCT-A detected active bleeding among 23 posttransplant patients: 10 of arterial origin and 13 venous, as proven either by angiography or during operation. Among 8 of the 11 patients who underwent angiographic imaging the arterial origin was embolized. For three patients the angiographic evaluation was not helpful to find the bleeding point. A cohort of 5 of 12 patients did not undergo angiographic evaluation and were followed by clinical and ultrasonographic findings. Seven patients underwent re-operating.
  
  
  CONCLUSIONS
  Management of the patients who were suspected to have active bleeding after renal or liver transplantation was benefitted by MDCT-A as an accurate and feasible screening modality.
authors.affiliation: Başkent University Faculty of Medicine, Radiology Department, Ankara, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Kirbas
authors.forename: N U
authors.initials: NU
authors.lastname: Tutar
authors.forename: F K
authors.initials: FK
authors.lastname: Emiroglu
authors.forename: M
authors.initials: M
authors.lastname: Coskun
authors.forename: M
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D021721:Balloon Occlusion; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007089:Image Enhancement; D016030:Kidney Transplantation / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed