Imaging in liver transplantation is aimed to evaluate donor and recipient for successful transplantation and its outcome.
Pre-transplant evaluation
Donor
- volume of liver
- parenchymal disease (diffuse or focal)
- vascular anatomy
- arterial variations
- venous variations
- biliary anatomy
Recipient
- vascular anatomy, e.g arterial variations, including enlarged or diminutive vessels
- see Milan criteria
Post-transplant evaluation
Normal findings in recipient
- perihepatic hematoma
- right-sided pleural effusion
- minimal ascites
- periportal edema
Complications
- rejection (can be diagnosed accurately with biopsy only)
- related to vascular anastomosis
- hepatic arterial thrombosis: most common vascular complication, occurring in 2-12% of transplants 3
- hepatic abscess 4
- biliary ischemia / stricture 4
- arterial pseudoaneurysm
- portal vein thrombosis/stenosis
- hepatic vein thrombosis
- IVC thrombosis
- related to biliary anastomosis
- bile leak
- biliary obstruction
- anastomotic / non-anastomotic strictures (infection, ischemia)
- calculus
- cholangitis
- sepsis
- recurrent disease
- posttransplantation lymphoproliferative disease
- biliary cast syndrome
- abdominal compartment syndrome
