Advances in TransplantologyLiver transplantationClinical Utility of Hepatic-Perfusion Computerized Tomography in Living-Donor Liver Transplantation: A Preliminary Study
Section snippets
Patients
This prospective study was conducted from August 2012 to March 2014. Institutional Review Board approval was received, and every patient gave written informed consent. Thirty-nine right-lobe liver graft transplant recipients (21 men and 18 women; mean age, 53 ± 7.4 years; age range, 43–68 years) who had undergone transplantation in our hospital or outside institutions were referred to the diagnostic radiology department for further evaluation of vascular complications diagnosed by means of
Results
All the patients with post-transplantation vascular complications successfully underwent perfusion CT imaging. The post-transplantation vascular complications are summarized in Table 1. There were no statistically significant differences in age (F: 2.647; P > .05) or sex (P > .05) distribution between the arterial and portal and hepatic venous complication groups.
The comparisons of the mean pre- and post-treatment perfusion parameters between the affected vascular territory regions and normal
Discussion
In post-transplantation liver tissue, it is essential to determine whether parenchymal necrosis, ischemia, biliary abscesses, or regional extensions are present [18], [19], [20]. Early diagnosis is crucial for successful management of these complications, and imaging plays an important role in the diagnosis of complications [1], [2], [7]. When vascular complications occur after liver transplantation, the transplantation surgeons need information regarding the following:
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Which vascular structure
Study Limitations
Our study had a few limitations. First, the cohort was relatively small. Therefore, the cutoff values for the hepatic arterial and hepatic venous complication groups must be confirmed in larger prospective studies. Perfusion CT imaging enables the quantitative evaluation of vascular complications in the graft parenchyma after LDLT and permits a quantitative evaluation of treatment response. More cases should be collected, and more data should be validated. Second, standard cutoff values for the
Conclusion
Perfusion CT imaging enabled an analysis of vascular regions, a functional assessment of the liver graft parenchyma, and a quantitative evaluation of the areas in the liver parenchyma affected by vascular complications. Moreover, it can assist with early detection of changes in hepatic perfusion and thus with early commencement of treatment. Unlike other imaging techniques, such as Doppler US and CT angiography, this method may have a potential role in predicting treatment responses and liver
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