Radiology 1985 Nov;157(2):339-44

Pediatric liver transplantation. Part II. Diagnostic imaging in postoperativ
management

Dominguez R, Young LW, Ledesma-Medina J, Cienfuegos J, Gartner JC, Bron KM,
Starzl TE 
Abstract
The postoperative diagnostic imaging examinations of 44 children who underwent
59 orthotopic liver transplantations were reviewed. The imaging modalities used
for the evaluation of suspected complications include plain roentgenography,
ultrasonography (US), computed tomography (CT), nuclear scintigraphy,
arteriography, percutaneous and operative cholangiography, and endoscopic
retrograde cholangiopancreatography. The main postoperative complications
included ischemia, thrombosis (hepatic artery and portal vein), infarction,
obstruction or leakage of the biliary anastomosis, hepatic and perihepatic
infection, and allograft rejection. US, the most frequently used abdominal
imaging modality, was best suited for detection of biliary duct dilatation,
fluid collections in or around the transplanted liver, and hepatic arterial,
inferior vena caval, and portal vein thrombosis. CT was especially helpful in
corroborating findings of infection and in locating abscesses. Technetium 99m
sulfur colloid (early- and late-phase imaging) provided a sensitive, although
nonspecific, means of assessing allograft vascularization and morphology.
Angiography showed vascularity most clearly, and cholangiography was the most
useful in the assessment of bile duct patency. A diagnostic imaging algorithm is
proposed for evaluation of suspected complications