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Diagnostic role of colour Doppler US at 1-year follow-up after orthotopic liver transplantation

Ruolo diagnostico dell’US color Doppler nel I anno di follow-up posttrapianto epatico (OLT)

  • Abdominal Radiology / Radiologia Addominale
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

This paper discusses the role of colour Doppler ultrasound (CDUS) in the midterm follow-up of patients after orthotopic liver transplantation (OLT).

Materials and methods

We retrospectively studied 134 patients — 102 men and 32 women, age range 21–68 years — who underwent liver transplantation between May 2006 and April 2007. In the first week after OLT, CDUS examination was performed daily in patients with anastomoses at a high risk of thrombosis, and on the basis of clinical and laboratory findings in other patients. After discharge, follow-up was performed 1, 3, 6 and 12 months after transplantation. Any new parenchymal focal lesion was studied by computed tomography (CT) and, where needed, biopsy.

Results

CDUS identified the following complications: 22 biliary (B), nine vascular (V) and seven focal lesions (FL). Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were, respectively: 79.2%, 97.3%, 86.3%, 95.5%, 94% (B), 100%, 99.2%, 88.9%, 100%, 99.3% (V) and 100%, 96.9%, 42.8%, 100%, 97% (FL). CDUS also showed 16 blood collections and eight suspected biliary collections (four of which were confirmed by percutaneous puncture).

Conclusions

CDUS is an essential diagnostic tool in the follow-up of OLT. An early diagnosis of complications can improve graft integrity and patient survival.

Riassunto

Obiettivi

Scopo del presente studio è discutere l’attuale ruolo dell’ecotomografia nel follow-up a medio termine del paziente sottoposto a trapianto epatico (OLT).

Materiali e metodi

Sono stati studiati retrospettivamente 134 pazienti, 102 maschi e 32 femmine di età compresa tra 21 e 68 anni, trapiantati tra maggio 2007 ed aprile 2008. Nella prima settimana post-OLT i controlli eco color Doppler sono stati giornalieri per le anastomosi a rischio di trombosi, ed in base al quadro clinico-laboratoristico negli altri casi. Dopo la dimissione, sono stati effettuati controlli a 1, 3, 6 e 12 mesi dall’intervento. Le focalità parenchimali di nuova comparsa sono state tutte studiate con tomografia computerizzata (TC) ed eventualmente sottoposte a biopsia.

Risultati

L’ecotomografia ha suggerito le seguenti complicanze: 22 biliari (B), 9 vascolari (V) e 7 lesioni focali (LF). Sensibilità, specificità, valore predittivo positivo, valore predittivo negativo ed accuratezza diagnostica dell’indagine sono stati rispettivamente: 79,2%, 97,3%, 86,3%, 95,5%, 94% (B), 100%, 100%, 100%, 100%, 100% (V) e 100%, 96,9%, 42,8%, 100%, 97% (LF). L’ecografia (US) ha inoltre dimostrato 16 raccolte ematiche ed 8 sospette raccolte biliari (di cui 4/8 confermate dalla puntura percutanea).

Conclusioni

L’US color Doppler è strumento diagnostico fondamentale nel follow-up post-OLT. Diagnosticare precocemente una complicanza può condizionare l’integrità del graft e la sopravvivenza del paziente.

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References/Bibliografia

  1. Starzl TE, Marchioro TL, Von Kaulla KN et al (1963) Homotransplantation of liver in humans. Surg Gynecol Obstet 117:659

    CAS  PubMed  Google Scholar 

  2. Nghiem HV, Tran K, Winter TC 3rd, Schmiedl UP et al (1996) Imaging of complications after liver transplantation. Radiographics 16:825–840

    CAS  PubMed  Google Scholar 

  3. Vaidya S, Dighe M, Kolokythas O et al (2007) Liver transplantation: vascular complications. Ultrasound quarterly 23:239–253

    Article  PubMed  Google Scholar 

  4. Dodd GD 3rd, Memel DS, Zajko AB et al (1994) Hepatic artery stenosis and thrombosis in transplant recipients: Doppler diagnosis with resistive index and systolic acceleration time. Radiology 192:657–661

    PubMed  Google Scholar 

  5. Vit A, De Candia A, Como G et al (2003) Doppler evaluation of arterial complications of adult orthotopic liver transplantation. J Clin Ultrasound Sep 31:339–345

    Article  Google Scholar 

  6. Tamsel S, Demirpolat G, Killi R et al (2007) Vascular complications after liver transplantation: evaluation with Doppler US. Abdom Imaging 32:339–347

    Article  PubMed  Google Scholar 

  7. De Candia A, Como G, Tedeschi L et al (2002) Color Doppler sonography of hepatic artery reconstruction in liver transplantation. J Clin Ultrasound 30:12–17

    Article  PubMed  Google Scholar 

  8. Sanchez-Urdazpal L, Gores G, Ward MD et al (1992) Ischemic-type biliary complications after orthotopic liver transplantation. Hepatology 16:49–53

    Article  CAS  PubMed  Google Scholar 

  9. Colonna JO 2nd, Shaked A, Gomes AS et al (1992) Biliary strictures complicating liver transplantation. Incidence, pathogenesis, management, and outcome. Ann Surg 216:344–352

    Article  PubMed  Google Scholar 

  10. Pirenne J, Van Gelder F, Coosemans W et al (2001) Type of donor aortic preservation solution and not cold ischemia time is a major determinant of biliary strictures after liver transplantation. Liver Transpl 7:540–545

    Article  CAS  PubMed  Google Scholar 

  11. Khuroo MS, Al Ashgar H, Khuroo NS et al (2005) Biliary disease after liver transplantation: the experience of the King Faisal Specialist Hospital and Research Center, Riyadh. J Gastroenterol Hepatol. 20:217–228

    Article  PubMed  Google Scholar 

  12. Verdonk RC, Buis CI, Porte RJ et al (2006) Biliary complications after liver transplantation: a review. Scand J Gastroenterol Suppl (243):89–101

  13. Hussaini SH, Sheridan MB, Davies M (1999) The predictive value of transabdominal ultrasonography in the diagnosis of biliary tract complications after orthotopic liver transplantation. Gut 45(6):900–903

    Article  CAS  PubMed  Google Scholar 

  14. Fung JJ, Jain A, Kwak EJ et al (2001) De novo malignancies after liver transplantation: a major cause of late death. Liver Transplantation 7(Suppl 1):S109–S118

    Article  CAS  PubMed  Google Scholar 

  15. Kinlen LJ (1985) Incidence of cancer in rheumatoid arthritis and other disorders after immunosuppressive treatment. Am J Med 78(suppl):S44–S49

    Article  Google Scholar 

  16. Taylor AEM, Shuster S (1992) Skin cancer after renal transplantation: the causal role of azathioprine. Acta Derm Venereol 72:115–119

    CAS  PubMed  Google Scholar 

  17. Mooradian DL, McCarthy JB, Komanduri KV et al (1992) Effects of transforming growth factor-beta 1 on human pulmonaryadenocarcinoma cell adhesion, motility, and invasion in vitro. J Natl Cancer Inst 84:523–537

    Article  CAS  PubMed  Google Scholar 

  18. Hojo M, Morimoto T, Maluccio M et al (1999) Cyclosporine induces cancer progression by a cell-autonomous mechanism. Nature 397:530–534

    Article  CAS  PubMed  Google Scholar 

  19. Penn I (1996) Posttransplantation de novo tumors in liver allograft recipients. Liver Transpl Surg 2:52–59

    Article  CAS  PubMed  Google Scholar 

  20. Jain AB, Yee LD, Nalesnik MA et al (1998) Comparative incidence of de novo nonlymphoid malignancies after liver transplantation under tacrolimus using Surveillance Epidemiologic End Result data. Transplantation 66:1193–1200

    Article  CAS  PubMed  Google Scholar 

  21. Berenguer M, Prieto M, Bustamante M et al (1998) Incidence of de novo neoplasms after liver transplantation. Med Clin 111:481–484

    CAS  Google Scholar 

  22. Sheil AGR (1995) Malignancy following liver transplantation: a report from the Australian Combined Liver Transplant Registry. Transplant Proc 27:1247

    CAS  PubMed  Google Scholar 

  23. Flattery M (1998) Incidence and treatment of cancer in transplant recipients. J Transpl Coord 8:105–110

    CAS  PubMed  Google Scholar 

  24. Haagsma EB, Hagens VE, Schaapveld M et al (2001) Increased cancer risk after liver transplantation: a populationbased study. J Hepatol 34:84–91

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Istituto di Radiologia Diagnostica ed Interventistica, A.S.O. San Giovanni Battista, Via Genova 3, 10126, Torino, Italy

    C. Gazzera, G. Isolato, S. Stola, F. Avogliero & G. Gandini

  2. Centro Trapianti di Liver, A.S.O. San Giovanni Battista, C.so Bramante 88, 10126, Torino, Italy

    A. Ricchiuti

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  1. C. Gazzera
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  2. G. Isolato
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  3. S. Stola
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  4. F. Avogliero
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  5. A. Ricchiuti
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  6. G. Gandini
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Correspondence to C. Gazzera.

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Gazzera, C., Isolato, G., Stola, S. et al. Diagnostic role of colour Doppler US at 1-year follow-up after orthotopic liver transplantation. Radiol med 115, 1304–1313 (2010). https://doi.org/10.1007/s11547-010-0562-8

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  • DOI: https://doi.org/10.1007/s11547-010-0562-8

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