Ischemic-type biliary lesions in liver transplant recipients: Evaluation with magnetic resonance cholangiography
Section snippets
Materials and methods
From January 1997 to June 2003, a series of 28 patients (20 men and 8 women; age range: 32 to 63 years; mean age: 49.5 ± 9.6 years) prospectively underwent magnetic resonance-imaging (MRI) and cholangiography (MRC) between 3 and 12 months after OLT. During this period, some subjects were examined more than once in case of both graft and patient survival. The MR examinations were performed for abnormal liver function tests and/or biliary ductal dilation at ultrasound. A written informed consent
Results
MRC studies were considered to be diagnostic by the two reviewers in 28 of the 28 patients. All diagnostic examinations well exhibit the biliary anatomy and the ductal anastomosis, that is an end-to-end choledococholedocostomy. MRC demonstrated strictures involving the hepatic bifurcation and the extrahepatic bile duct of the graft in 25 patients; a concomitant thickening of the biliary wall was described in 18 out of these 25 subjects.
MRC also showed sludge or stones formation in the donor
Discussion
The early diagnosis and correct management of biliary complications are important elements for ensuring graft and patient survival after OLT, and the diagnostic workup has been repeatedly reviewed in an attempt to reach the most accurate strategy.8, 9, 10
The main imaging examinations used for this purpose are ultrasound and T-tube cholangiography. However, after the removal of a T-tube (if used), the only mean of directly visualizing the biliary system in the past was to use invasive
References (18)
- et al.
Biliary complications in pediatric living related liver transplantation
Surgery
(1998) - et al.
Biliary tract complications after orthotopic liver transplantation in adult patients
Transplant Proc
(2002) - et al.
Biliary complications after pediatric liver transplantation revisited
Transplant Proc
(2003) - et al.
Imaging in liver transplantation
Radiol Clin North Am
(1996) - et al.
Detection of biliary complications after orthotopic liver transplantation with MR cholangiography
Magn Reson Imaging
(2001) Consensus conference on indications of liver transplantation
Hepatology
(1994)- et al.
The incidence, timing, and management of biliary tract complications after orthotopic liver transplantation
Ann Surg
(1994) - et al.
Incidence and management of biliary complications after 291 liver transplants following the introduction of transcystic stenting
Transplantation
(1998) - et al.
Diagnostic features and clinical outcome of ischemic-type biliary complications after liver transplantation
Hepatology
(1993)
Cited by (35)
Postoperative imaging of living donor liver transplantation complications
2018, Egyptian Journal of Radiology and Nuclear MedicineCitation Excerpt :In one case, the MRCP diagnosed anastomotic biliary stricture without significant dilatation of the intrahepatic biliary radicles. Boraschi et al. reported a sensitivity of 93%, specificity of 92%, a positive predictive value of 86% and a negative predictive value of 96% for MRCP in detecting post-LTX biliary complications [13]. Biliary leak (which occurred by in 4 cases) in our study, was a serious complication as the incidence of sepsis after second exploration for biliary leakage was 100%.
Graft complications following orthotopic liver transplantation: Role of non-invasive cross-sectional imaging techniques
2016, European Journal of RadiologyCitation Excerpt :Using MRC, most of ITBL show a lengthy stricture that frequently involves the right and left hepatic ducts and the hepatic bifurcation, which is a prevalent localization for ischemic injures after OLT [41]. Another characteristic MR feature of ITBL is represented by wall thickening of the graft extra-hepatic biliary ducts, that can be associated to biliary sludge, stones or casts formation [34,40]. All these biliary findings can be better demonstrated at 3.0-T device [50] (Fig. 11).
Biliary complications following orthotopic liver transplantation: May contrast-enhanced MR Cholangiography provide additional information?
2016, European Journal of Radiology OpenCitation Excerpt :Adverse events such as biliary strictures, stones and leakages, can occur in a percentage ranging between 5.8% and 24.5% of adult liver transplant recipients and their prompt identification and appropriate management is essential for the survival of graft and patient [3,4]. Several authors [5–11] have reported that MR Cholangiography (MRC) has good results in identifying biliary complications following liver transplantation, suggesting that it may be a reliable non-invasive diagnostic method for imaging the biliary tract in these patients. Mangafodipir trisodium (Mn-DPDP, Teslascan®) is a contrast agent that consists of an organic ligand, fodipir (DPDP) and manganese (Mn) [12].
Technical Problems: Biliary
2015, Transplantation of the Liver: Third EditionIs MRCP equivalent to ERCP for diagnosing biliary obstruction in orthotopic liver transplant recipients? A meta-analysis
2011, Gastrointestinal EndoscopyCitation Excerpt :Zoepf et al33 was excluded because the primary purpose of the study was to compare ERC with various noninvasive methods such as US, MRCP, and CT. The 2004 study by Boraschi et al34 was excluded because it appeared to be a subset of their 2001 study, which was included in the final analysis. Linhares et al30 and Ott et al31 were excluded because most of the MRCPs were performed for routine follow-up and not for suspicion of biliary obstruction.
Biliary strictures after liver transplantation. Predictive factors for response to endoscopic management and long-term outcome
2008, American Journal of the Medical Sciences