Diagnosis of complications in auxiliary heterotopic partial-liver transplant recipients: spiral CT findings

Imaging is important after liver transplantation to determine possible complications. The purpose of this study was to evaluate the spiral CT findings in auxiliary heterotopic partial liver transplant recipients and to determine the incidence of these complications with spiral CT imaging. Twenty-one patients had auxiliary heterotopic partial liver transplantation at our institution during a two-year period. There were 16 males and five females with an age range of 4-58 years. All graft livers were transplanted to the right subhepatic space. Spiral CT was performed at least once after transplantation in twenty of the patients in order to evaluate vascular structures and determine possible complications. The 5mm and/or 8 mm thick sections were obtained through the abdomen before and after IV-contrast at the portal phase. Spiral CT findings were compared with ultrasonography (n=15), digital subtraction angiography (n=8), percutaneous transhepatic cholangiography (n=3) and laparotomy findings (n=2). Complications were detected in fourteen of the twenty-one patients. Spiral CT detected a total of 19/23 (83%) vascular complications in this study. All biliary complications (100%), 13/16 (81%) parenchymal changes and 14/14 (100%) different forms of fluid collections were also detected by spiral CT. In three patients with focal lesions, the infarcts were detected only by CT. It was not able to detect hepatic artery stenosis and one of the pseudoaneurysms of the hepatic artery. It is suggested that SCT in particular should be used in the evaluation of biliary complications, fluid collections and parenchymal changes of graft liver. It could be used in combination with other non-invasive imaging methods for evaluation of vascular structures.