title: Nonvascular post-liver transplantation complications: from US screening to cross-sectional and interventional imaging.
abstract: Orthotopic liver transplantation is becoming an increasingly routine procedure for a variety of benign and malignant diseases of the liver and biliary system. Continued improvements in surgical techniques and post-transplantation immunosuppression regimens have resulted in better graft and patient survival. A number of potentially treatable nonvascular complications of liver transplantation are visible at imaging, and accurate diagnosis of these complications allows patients to benefit from potential treatment options. Biliary complications include stricture (anastomotic and nonanastomotic), leak, biloma formation, and development of intraductal stones. Pathologic conditions, including hepatitis C infection, hepatocellular carcinoma, hepatic steatosis, and primary sclerosing cholangitis, may recur after liver transplantation. Transplant patients are at increased risk for developing de novo malignancy, including post-transplantation lymphoproliferative disorder, which results from immunosuppression. Patients are also at increased risk for systemic infection from immunosuppression, and patients with hepatic artery and biliary complications are at increased risk for liver abscess. Transplant recipients are typically followed with serial liver function testing; abnormal serum liver function test results may be the first indication that there is a problem with the transplanted liver. Ultrasonography is typically the first imaging test performed to try to identify the cause of abnormal liver function test results. Computed tomography, magnetic resonance imaging, angiography, and/or cholangiography may be necessary for further evaluation. Accurately diagnosing nonvascular complications of liver transplantation that are visible at imaging is critically important for patients to benefit from appropriate treatment.
authors.affiliation: From the Abdominal Imaging Division, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322 (J.C.C., C.C.M., J.C.T., W.E.T., P.K.M.); and Abdominal Imaging Division, Department of Imaging, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia (D.A.A.).
authors.forename: Juan C
authors.initials: JC
authors.lastname: Camacho
authors.forename: Courtney
authors.initials: C
authors.lastname: Coursey-Moreno
authors.forename: Juan C
authors.initials: JC
authors.lastname: Telleria
authors.forename: Diego A
authors.initials: DA
authors.lastname: Aguirre
authors.forename: William E
authors.initials: WE
authors.lastname: Torres
authors.forename: Pardeep K
authors.initials: PK
authors.lastname: Mittal
mesh_terms: D003287:Contrast Media; D003952:Diagnostic Imaging; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation; D011183:Postoperative Complications / Q000175:diagnosis*; D012008:Recurrence
chemical_list: D003287:Contrast Media