title: Detection of Portal Vein Stenosis by Technetium-99m-Diethylenetriaminepentaacetic Acid-Galactosyl Human Serum Albumin Liver Scintigraphy after Living-Donor Liver Transplantation.
abstract: OBJECTIVE
  To investigate portal vein stenosis after living-donor liver transplantation by liver scintigraphy.
  
  
  METHODS
  A 63-year-old woman with hepatic cirrhosis due to autoimmune hepatitis underwent living-donor liver transplantation using a graft donated by her daughter. Technetium-99m-diethylenetriaminepentaacetic acid-galactosyl human serum albumin (Tc-99m-GSA) scintigraphy was used to determine the maximum rate of Tc-99m-GSA removal (GSA-Rmax) by hepatocytes, as a parameter of hepatic functional reserve.
  
  
  RESULTS
  Conventional liver function parameters on laboratory tests and graft volume on computed tomography (CT) were almost unchanged at postoperative month (POM) 12. GSA-Rmax was 0.11 mg/min before surgery and increased 5-fold to approximately 0.5 mg/min at POM 1 and 3, followed by a decrease to 0.25 mg/min at POM 6 and 12. Enhanced CT did not detect blood flow in the intra- or extrahepatic portions of the portal vein at POM 12. The portal vein stenosis was dilated with a balloon catheter, followed by deployment of a self-expanding stent across the stenotic segment via the transileocolic vein. GSA-Rmax recovered to 0.5 mg/min at POM 15, and subsequently remained high.
  
  
  CONCLUSIONS
  Decreased GSA-Rmax at POM 6 indicated that the portal vein stenosis was affecting graft function. Tc-99m-GSA liver scintigraphy may be a useful noninvasive method for evaluation of graft functional reserve.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kaibori
authors.forename: Shunji
authors.initials: S
authors.lastname: Kariya
authors.forename: Kosuke
authors.initials: K
authors.lastname: Matsui
authors.forename: Morihiko
authors.initials: M
authors.lastname: Ishizaki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikeda
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Nakahashi
authors.forename: Junko
authors.initials: J
authors.lastname: Hirohara
authors.forename: Sang Kil
authors.initials: SK
authors.lastname: Ha-Kawa
authors.forename: Noboru
authors.initials: N
authors.lastname: Tanigawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sawada
authors.forename: Kazuichi
authors.initials: K
authors.lastname: Okazaki
authors.forename: A-Hon
authors.initials: AH
authors.lastname: Kwon
mesh_terms: D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000295:instrumentation; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015607:Stents; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate