Detecting biliary complications following liver transplantation with contrast-enhanced ultrasound

Liver transplantation is the primary therapeutic choice for end-stage liver disease. Currently, biliary complications are among the main factors affecting the survival rate and quality of life of liver transplant recipients. Nevertheless, the clinical manifestations of biliary complications following liver transplantation are often non-specific, making early diagnosis and timely treatment crucial for improving patient outcomes. Ultrasound is the preferred imaging method following liver transplantation. Importantly, contrast-enhanced ultrasound, with the administration of contrast agents, can improve the resolution of biliary images and enable real-time, dynamic visualization of microcirculation perfusion in the biliary system and surrounding tissues. The present article describes the normal ultrasonic features of the biliary system following liver transplantation and briefly reviews the progress in the ultrasonic diagnosis of common biliary complications, including anastomotic biliary strictures, non-anastomotic biliary strictures, biliary leakage, biloma, and bile sludge/bile stone.