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Contrast-Enhanced Ultrasound for identifying circulatory complications after liver transplants in children

Alvaro Torres1,2, Seppo K Koskinen1, Henrik Gjertsen1,3

  • 1Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.

Pediatric Transplantation
|December 12, 2018
PubMed

Insights

Contrast-enhanced ultrasound (CEUS) effectively identifies circulatory issues in pediatric liver transplant recipients. This safe, non-invasive imaging technique shows promise for post-transplant monitoring in children.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Transplantation Medicine

Background:

  • Liver transplantation in children presents unique challenges for monitoring circulatory complications.
  • Off-label use of contrast-enhanced ultrasound (CEUS) is explored for pediatric liver transplant recipients.
  • Early detection of vascular complications is crucial for graft survival.

Observation:

  • 74 CEUS examinations were retrospectively analyzed in 34 pediatric liver transplant patients.
  • The majority of examinations (53%) were in children aged 2 years or younger, with 82% performed within 30 days post-transplant.
  • Common indications for transplantation included biliary atresia (38%), cholestatic disease (62%), metabolic disease (11%), and re-transplantation (8%).

Findings:

  • CEUS demonstrated high positive predictive value (PPV) for arterial complications (80%) and portal vein complications (66.7%).
  • The negative predictive value (NPV) for CEUS in detecting these complications was 100%.
  • CEUS improved visualization of arterial blood flow in 28% of examinations where it was initially unclear.

Implications:

  • CEUS is a valuable, non-invasive tool for diagnosing circulatory complications in pediatric liver transplant patients.
  • Further research and regulatory approval are needed to establish CEUS as a standard post-transplant imaging modality.
  • This study supports the expanded use of CEUS in pediatric transplant care.

Keywords:
circulatory complicationscontrast-enhanced ultrasoundliver transplantoff-labelpediatric

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