• LIVER
• OLT
• TRANSPLANTATION

Purpose
To evaluate the usefulness of MDCT in the detection of early abdominal complications after orthotopic liver transplantation (OLT).

Material and Methods
From September 2009 to October 2013 we retrospectively enrolled 170 subjects who underwent MDCT within the first 90 days after OLT at the Pisa University Hospital. Inclusion criteria were represented by clinical-laboratory and/or echo-color Doppler abnormalities. The examinations were performed at 64-slice MDCT scanner and the protocol study always included pre- and post-contrast multi-phasic acquisitions. All images were reviewed by two radiologists in conference and imaging results were correlated with DSA, trans-Kehr cholangiography/ERCP, surgery, clinical-laboratory and imaging follow-up.

Results
No significant complication was found in 142 patients, while in the remaining 28 patients vascular complications (hepatic artery thrombosis HAT, n=5 and stenosis HAS, n=5; portal vein thrombosis, n=4; cava vein thrombosis, n=1; arterial bleeding, n=1), biliary complications (anastomotic leak with biloma, n=6), 4 graft complications (abscess, n=1; extended areas of impaired perfusion, n=3), adrenal hemorrhage (n=1) and bowel perforation (n=1) were identified. Four false positive cases (3 hepatic artery stenoses and 1 hepatic artery rupture) and one false negative (biloma) were diagnosed on MDCT. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of MDCT in the identification of various complications were 96%, 97%, 87%, 99% and 97%, respectively.

Conclusion
MDCT is extremely reliable in the identification of early abdominal complications of liver transplant patients.