Contrast-enhanced multidetector-CT cholangiography after living donor liver transplantation
Tobias Schroeder1, Arnold Radtke, Jörg F Debatin
1Department of Diagnostic & Interventional Radiology, University Hospital Essen, Germany. Tobias.Schroeder@uni-essen.de
Insights
Postoperative contrast-enhanced multi-detector CT cholangiography (ceMDCT-CA) is a feasible imaging technique for assessing biliary morphology in liver donors and recipients. This method shows promise for non-invasive evaluation of the biliary tree after liver transplantation.
Area of Science:
- Hepatobiliary Surgery
- Diagnostic Imaging
- Transplant Surgery
Background:
- Living donor liver transplantation requires careful postoperative monitoring.
- Assessing biliary complications like leakage or obstruction is crucial.
Purpose of the Study:
- To evaluate the feasibility of contrast-enhanced multi-detector CT cholangiography (ceMDCT-CA) postoperatively.
- To assess biliary morphology in living liver donors and transplant recipients.
Main Methods:
- Prospective study of 15 donors and 11 recipients undergoing ceMDCT-CA.
- Intravenous injection of a biliary contrast agent followed by 1mm slice CT acquisition.
- Quantitative and qualitative analysis of biliary opacification, correlated with bilirubin levels.
Main Results:
- ceMDCT-CA provided diagnostic biliary delineation in all donors and 7/11 recipients.
- Biliary opacification was generally higher in donors.
- Focal biliary constrictions and perihepatic fluid collections were noted, but no biliary fistulas visualized.
Conclusions:
- ceMDCT-CA is a promising, non-invasive tool for postoperative biliary assessment.
- It aids in evaluating biliary morphology in liver donors and recipients.
Background/Aims:
To prospectively evaluate the feasibility of postoperative contrast enhanced Multi-detector-CT cholangiography (ceMDCT-CA) in living liver donors and transplant recipients.
Methodology:
Fifteen donors and 11 recipients of a right hepatic lobe underwent ceMDCT-CA. Six donors were admitted to exclude biliary leakage; 9 donors and 11 recipients were examined to exclude postoperative biliary obstruction. The examination protocol included the intravenous short-infusion of 100 mL of a biliary contrast agent. CT cholangiography data was acquired with a slice thickness of 1 mm. This scan was followed by examination of the upper abdomen in a venous phase. Data sets were evaluated quantitatively by measurement of the biliary opacification, and qualitatively on the basis of a scale ranging from 1 (non-diagnostic) to 4 (excellent). Opacification was correlated with postoperative serum bilirubin level.
Results:
CT data provided diagnostic delineation of the biliary tree in all 15 donors and seven of 11 recipients; in 4 recipients the degree of biliary opacification was non-diagnostic. Biliary opacification was generally higher in the donor collective. Four donors and 3 recipients presented a moderate focal biliary constriction without elevation of laboratory values. Six patients showed postoperative fluid collections suggestive of perihepatic biloma, however no biliary fistula could be visualized.
Conclusions:
CeMDCT-CA represents a promising tool to non-invasively assess the postoperative biliary morphology in living liver donors and transplant recipients.