Imaging in liver transplantation

Imaging in liver transplantation is aimed to evaluate donor and recipient for successful transplantation and its outcome.

Types of liver transplant are discussed here.

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