Auxiliary partial liver transplantation: imaging evaluation in 10 patients

Auxiliary partial liver transplantation involves placement of a heterotopic graft in the subhepatic space, with the liver of the recipient left unaltered. We studied the values of three imaging procedures (Doppler sonography, diisopropyl iminodiacetic acid [DISIDA] scintigraphy, and cholangiography) to evaluate the transplant and the native liver after surgery in 10 patients. Special attention was paid to the Doppler waveform of the hepatic artery of the graft and to the resistive index. An increase of the index above 0.80 was not specific for, but was always associated with graft dysfunction (rejection, primary nonfunction, multiple organ failure, or portal vein thrombosis). DISIDA scintigraphy also lacked specificity and was of limited value in the detection of postoperative complications. It proved useful in routine imaging to monitor atrophy of the native liver and hypertrophy of the transplant. Cholangiography was useful for visualization of the biliary tree. Our experience suggests that these three noninvasive imaging procedures are sufficient for the proper postoperative evaluation of patients after auxiliary partial liver transplantation.