Simultaneous evaluation of portal hemodynamics and liver function by scintiphotosplenoportography in pediatric recipients of living-donor liver transplants.
OBJECTIVE
The aim of this study was to simultaneously evaluate portal hemodynamics and liver function by scintiphotosplenoportography (SSP) using technetium-99m-diethylenetriaminepentaacetic asid-galactosyl-human serum albumin (99mTc-GSA) in recipients of living-donor liver transplants (LDLT).


METHODS
Three LDLT recipients with biliary atresia who underwent SSP using 99mTc-GSA were studied. The clearance index of 99mTc-GSA (HH15) was calculated by dividing the radioactivity of the heart region of interest (ROI) 15 minutes after injection (H15) by that of the heart ROI 3 minutes after injection (H3), (HH15=H15/H3). The hepatic uptake ratio of 99mTc-GSA (LHL15) was calculated by dividing the radioactivity of the liver ROI at 15 minutes (L15) by H15 plus L15, (LHL15=L15/(H15+L15)). H/L15 (HH15/LHL15).


RESULTS
Patient 1: On SSP before transplantation, digital images showed hepatofugal flow, but not the portal vein in early phase (HH15: 0.647, LHL15: 0.861, H/L15: 0.751). On SSP after transplantation, digital images showed the portal vein clearly, and the hepatofugal flow had disappeared (HH15: 0.633, LHL15: 0.971, H/L15: 0.652). Patient 2: On SSP before transplantation, digital images showed hepatofugal flow, and the liver was slightly visible in early phase (HH15: 0.673, LHL15: 0.869, H/L15: 0.774). Patient 3: On SSP before transplantation, digital images showed splenorenal shunt, but not the liver in early phase (HH15: 0.697, LHL15: 0.838, H/L15: 0.832).


CONCLUSIONS
SSP using 99mTc-GSA is useful for the simultaneous evaluation of portal hemodynamics and liver function in pediatric recipients of LDLT.
Yoshida
Hiroshi
H
Department of Surgery, Nippon Medical School, Tokyo, Japan. hiroshiy@nms.ac.jp
Mamada
Yasuhiro
Y
Taniai
Nobuhiko
N
Hirakata
Atsushi
A
Kawano
Yoichi
Y
Kakinuma
Daisuke
D
Mineta
Sho
S
Tajiri
Takashi
T
D001656:Biliary Atresia / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007272:Injections, Intralymphatic; D008102:Liver Circulation / Q000502:physiology*; D008111:Liver Function Tests; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D011168:Portal System / Q000503:physiopathology*; D011172:Portography / Q000379:methods*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D013154:Spleen; D013668:Technetium Tc 99m Aggregated Albumin / Q000008:administration & dosage; D016284:Technetium Tc 99m Pentetate / Q000008:administration & dosage
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate