CT appearance of impaired lymphatic drainage in liver transplants

Early postoperative CT scans of three patients who had undergone liver transplantation show hypodense areas surrounding the portal venous system and to a lesser extent the intrahepatic inferior vena cava. These changes were considered to represent dilated lymphatic vessels caused by impaired lymphatic drainage of the transplant after total interruption of the lymphatic vessels at surgery. This hypothesis was tested in three piglets after complete surgical interruption of the lymphatic vessels of the liver. Results of histologic examinations and an additional long-term follow-up CT study in one patient suggest that hypodense periportal and pericaval areas are a reversible CT finding in liver transplants caused by lymph stasis.