Differentiation of liver transplantation complications by quantitative analysis of dynamic hepatobiliary scintigraphy

Abstract Introduction Hepatobiliary scintigraphy (HS) is a noninvasive imaging technique whose use in the follow-up of liver transplantation has not been duly documented. The main objective of this study is to describe the experience of using this technique to detect biliary complications in pediatric patients following liver transplantation. Materials and Methods A retrospective, observational, and descriptive study involving 86 pediatric patients who had undergone liver transplantation between 2013 and 2018. Of the 86, 31 had undergone at least one HS during their postoperative period. Results A total of 45 studies were performed on 31 patients (36% of the patients undergoing transplantation during that time period). Patient ages ranged from 5 to 204 months (mean = 50 months). A total of 22 transplants (71%) were from living donors and 9 (29%) were from cadaveric donors. Of the 45 studies, 22 were positive for biliary complications, and all of them had an impact on clinical decision-making. The remaining 23 studies were negative. Of these 23, 19 continued under medical treatment and the other four underwent an additional intervention with positive surgical outcomes in all cases. All scintigraphy studies revealed hepatocellular dysfunction and cholestasis. Conclusion The HS is a useful, noninvasive, and diagnostic procedure for the early diagnosis of biliary complications that may impact the evolution of disease in liver transplant patients. It allows the treating physician to make a more informed decision regarding expectant management, surgical management, or a less invasive course of action for transplantation complications.

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Post-Liver Transplantation Complications

Pediatric Emergency Medicine ◽

10.1016/b978-141600087-7.50084-2 ◽

2008 ◽

pp. 619-624

Author(s):

Samir S. Shah

Keyword(s):

Liver Transplantation ◽

Transplantation Complications

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Post Liver Transplantation Complications: Early Surgical Complications

Pediatric Liver Intensive Care ◽

10.1007/978-981-13-1304-2_20 ◽

2018 ◽

pp. 127-132

Author(s):

Gomathy Narasimhan

Keyword(s):

Liver Transplantation ◽

Surgical Complications ◽

Transplantation Complications

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Parameters obtained by hepatobiliary scintigraphy have significant correlation with biochemical factors early after liver transplantation

Acta Radiologica ◽

10.1080/02841850701342120 ◽

2007 ◽

Vol 48 (6) ◽

pp. 597-604 ◽

Cited By ~ 5

Author(s):

H. A. Kansoul ◽

R. Axelsson ◽

S. Yamamoto ◽

I. Savicheva ◽

P. Aspelin ◽

...

Keyword(s):

Liver Transplantation ◽

Half Life ◽

Biochemical Parameters ◽

Graft Function ◽

Normal Liver ◽

Hepatobiliary Scintigraphy ◽

Liver Uptake ◽

Significant Difference ◽

Amyloid Polyneuropathy ◽

End Stage

Background: Early postoperative hepatobiliary scintigraphy after liver transplantation is performed worldwide, but data on its significance for graft function are currently limited. Purpose: To examine the correlation between the result of early postoperative hepatobiliary scintigraphy and pre- and postoperative biochemical parameters in liver transplantation (LTx) patients. Material and Methods: Six parameters of hepatobiliary scintigraphy using 99mTc mebrofenin were statistically analyzed in 108 LTx patients: 1) half-life of the activity of elimination of mebrofenin from the blood; 2) total clearance of mebrofenin from the blood due to all possible routes; 3) half-life of the activity due to liver uptake; 4) clearance of mebrofenin from the blood due to liver uptake; 5) time to maximal uptake in the liver; and 6) the hepatic extraction fraction (HEF) and biochemical data. Analysis between patients with preoperative normal liver function, familial amyloid polyneuropathy (FAP), and end-stage liver disease (non-FAP) was also performed. Results: Univariate and multivariate analysis revealed that total bilirubin postoperative day 3 correlated with all three scintigraphic parameters, and peak aspartate aminotransferase and alanine aminotransferase correlated with HEF. The analysis between patients with FAP and non-FAP revealed no significant difference of scintigraphic data between the two groups. Conclusion: A significant correlation between early postoperative scintigraphic results and biochemical parameters was demonstrated.

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Ischemic Complications after Liver Transplantation

Digestive Disease Interventions ◽

10.1055/s-0038-1667343 ◽

2018 ◽

Vol 02 (03) ◽

pp. 244-248

Author(s):

Martin Montenovo ◽

Christopher Ingraham

Keyword(s):

Liver Transplantation ◽

Patient Survival ◽

Vascular Complications ◽

Biliary Tree ◽

Biliary Complications ◽

Surgical Anastomosis ◽

Biliary Leak ◽

The Past ◽

Ischemic Complications ◽

Transplantation Complications

AbstractDespite major advances in the field of liver transplantation over the past few decades with both increased graft and patient survival, biliary complications still occur in many patients after liver transplantation. Complications can range from a biliary leak or biloma to strictures most commonly involving the surgical anastomosis, or elsewhere in the biliary tree. Etiologies of these complications include surgical technique, rejection, complications secondary to infection, and vascular complications causing ischemia of the bile ducts. Biliary complications, particularly biliary ischemia, can cause significant morbidity to the patient, and may require multiple endoscopic, endovascular, or percutaneous therapies for successful treatment, or even retransplantation in severe cases. This review will provide an overview of common biliary complications with a focus on biliary ischemia.

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The impact of hepatitis C virus infection on early post-liver transplantation complications and early graft function in a single low-volume liver transplant center

Acta medica Lituanica ◽

10.6001/actamedica.v22i1.3073 ◽

2015 ◽

Vol 22 (1) ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Arida Buivydienė ◽

Viktorija Basytė ◽

Laura Mašalaitė ◽

Danguolė Stanislovaitytė ◽

Jurgita Adomavičiūtė ◽

...

Keyword(s):

Liver Transplantation ◽

Graft Function ◽

Vascular Complications ◽

Hcv Infection ◽

End Stage Liver Disease ◽

Transplant Center ◽

Early Graft ◽

Transplantation Complications ◽

End Stage ◽

The Impact

Background. End-stage liver disease associated with hepatitis C virus (HCV) infection has become one of the leading indications for liver transplantation. The effect of HCV infection on patients and long-term graft survival after orthotopic liver transplantation is well known. The aim of this study was to evaluate the impact of HCV infection on early post-liver transplantation complications and early graft function. Materials and methods. Between July 2005 and February 2015 60 cadaveric orthotopic liver transplantations were performed in 58 adult patients at the Vilnius University Hospital Santariškių Clinics. We retrospectively reviewed our low-volume liver transplant center experience. To evaluate the changes that occurred in HCV-positive and HCV-negative transplant recipients, the study population was divided into two groups according to their HCV status. Statistical analysis was performed using the Microsoft Excel and SPSS 20.0 program. Group differences and data reliability were determined by the Student’s t-test. Results. For 21 patients (35%) the indication for liver transplantation was end-stage liver disease due to HCV infection and for 39 patients (65%) there was another (non-HCV infection) indication. Overall, 29 patients (48%) have developed early biliary and/or vascular complications after transplantation: vascular complications were observed in 17 patients (28%) and biliary complications were observed in 12 patients (20%). Early graft function was good or fair in 52 patients (87%), primary dysfunction was observed in 8 (13%) patients. Conclusions. The incidence of early post-transplant complications and early graft dysfunction had no statistically significant difference according to the patient’s HCV status.

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