Perfusion defects detected after liver transplantation on multidetector computerized tomography: short- and long-term...

Perfusion defects are sometimes found during the follow-up computerized tomography (CT) after liver transplantation (OLT). This study sought to determine the short- and long-term outcomes of perfusion defects observed after OLT with the use of multidetector CT.

From February 4, 2004, to December 8, 2011, a total 46 LTs were performed in our hospital owing to end-stage liver cirrhosis (n = 43), liver cirrhosis with hepatocellular carcinoma (HCC; n = 1), combined HCC with cholangiocellular carcinoma (CCC; n = 1), or hepatic failure from acute hepatitis A (n = 1). The transplanted livers were procured from cadaveric (n = 24) or living related donors (n = 22). The average age of the recipient was 53.3 ± 10.4 years. The male-female ratio was 30:16. Postoperative multidetector CT was performed with a dynamic sequence in 203 examinations and with a portal phase in 46 examinations. The contrast media was Radisense. The rate of injection of 120 mL was 3 mL/s with a power injector; the iodine concentration was 300 or 370 mg/dL. Follow-up ranged from 3 months 3 days to 7 years 363 days. We classified perfusion defects as chronic segmental or subsegmental benign ischemia, transient focal perfusion defects, benign subcapsular ischemia, or fatal whole liver perfusion defects.

There were 3 cases of chronic segmental or subsegmental benign ischemia, 8 focal transient perfusion defects, 1 benign subcapsular ischemia, and 4 fatal whole liver perfusion defects. Except the fatal cases, all other perfusion defects occurred in the courses of benign conditions without resection or reoperation.

Most perfusion defects were benign and uneventful, requiring no treatment, with the exception of fatal whole liver perfusion defects, which resulted in death after detection.