[Complications and liver transplantation: diagnostic strategy]

Area of Science:

• Hepatology
• Transplant Surgery
• Diagnostic Imaging

Background:

• Liver transplantation is the primary treatment for end-stage liver failure.
• Survival rates have improved due to advancements in surgical techniques, immunosuppression, and organ allocation.
• In 1990, France performed 670 liver transplantations, with a 2-year adult survival rate of 65%.

Purpose of the Study:

• To highlight the critical role of imaging in liver transplantation.
• To outline the diagnostic approach for postoperative surveillance and complication detection.
• To emphasize the utility of interventional radiology in managing transplant complications.

Main Methods:

• Systematic postoperative surveillance including laboratory parameters, histology, and imaging.
• Utilizing imaging for pre-transplantation assessment and immediate/long-term follow-up.
• Employing angiography and CT scans for specific complications like vascular issues and collections.

Main Results:

• Imaging aids in assessing transplant vitality and detecting four main complication types: vascular, biliary, rejection, and infection.
• The diagnostic sequence prioritizes laboratory findings, histology, and then imaging.
• Imaging helps rule out specific causes for abnormal lab results, guiding treatment decisions.

Conclusions:

• Imaging is essential for liver transplant follow-up, aiding in complication detection and management.
• Interventional radiology offers a less invasive alternative to surgery for managing vascular, biliary, and infectious complications.
• A structured diagnostic approach improves patient outcomes after liver transplantation.