Hepatic perfusion abnormalities after liver transplantation

The angiographic and CT findings in a liver transplant patient with perioperative hepatic ischemia are reported. Extensive arterial collaterals and unusual portal-to-hepatic venous shunting in the transplanted liver were observed. Post-transplant clinical, laboratory, and CT findings were compatible with partial right lobe hepatic infarction that was confirmed at autopsy. The possible relationship between the ischemic damage and intrahepatic shunting is discussed. The need for caution during preoperative angiography in potential liver transplant recipients is emphasized.