US of liver transplants: normal and abnormal

Area of Science:

• Medical Imaging
• Transplant Surgery
• Hepatology

Background:

• Whole-liver transplantation is a standard treatment for end-stage liver disease.
• Donor liver shortages have increased the use of split-liver and living donor liver transplantation.
• Early detection of complications is vital for successful liver transplant outcomes.

Purpose of the Study:

• To highlight the role of ultrasonography (US) in identifying early and delayed complications following all types of liver transplantation.
• To provide a comprehensive overview of potential complications encountered in liver transplant recipients.
• To emphasize the importance of understanding US findings for accurate diagnosis and patient management.

Main Methods:

• Review of common vascular complications (e.g., hepatic artery thrombosis/stenosis, portal vein issues, IVC complications, pseudoaneurysms).
• Identification of frequent biliary complications (e.g., leaks, strictures, stones, sphincter of Oddi dysfunction).
• Discussion of neoplastic diseases (recurrent neoplasia, PTLD) and parenchymal abnormalities (focal masses, diffuse changes).
• Recognition of common post-transplant findings like perihepatic fluid collections and ascites.

Main Results:

• Ultrasonography (US) is the primary imaging modality for detecting and monitoring liver transplant complications.
• Vascular complications are common and include issues with hepatic artery, portal vein, and inferior vena cava.
• Biliary complications, neoplastic diseases, and parenchymal abnormalities require careful US evaluation.
• Perihepatic fluid collections and ascites are frequently observed post-transplantation.

Conclusions:

• Familiarity with liver transplantation surgical techniques and normal US appearance is essential.
• US enables early detection of complications, preventing misdiagnosis and guiding appropriate management.
• Prompt US assessment is critical for optimizing outcomes in liver transplant recipients.