Arteriography and portal venography on routine follow-up after orthotopic liver transplantation

Invest Radiol. 2000 Nov;35(11):653-60. doi: 10.1097/00004424-200011000-00002.

Abstract

Rationale and objectives: To describe the findings of routinely performed angiographic examinations in patients at discharge 2 months after orthotopic liver transplantation (OLT) and at follow-up 1 year later.

Methods: The findings of 315 angiographic examinations performed in 190 patients 2 months and 1 year after OLT were reviewed, and the changes at the anastomotic site of the hepatic artery and portal vein were analyzed.

Results: Routine angiography 2 months and 1 year after OLT demonstrated a normal anastomosis or low-grade stenosis in 82% and 84% of the patients (hepatic artery) and in 88% and 84% (portal vein), respectively. High-grade stenosis occurred in 9% and 5% of the patients (hepatic artery) and in 3% and 5% (portal vein). Hepatic artery occlusion and portal vein occlusion were observed in two and seven patients and in one and three patients, respectively. In 76% of patients, the anastomotic site of the hepatic artery did not change significantly. In eight patients, a normal anastomosis or a low- or medium-grade stenosis developed into high-grade stenosis or occlusion. Conversely, in nine patients, medium- or high-grade stenosis developed into a normal anastomosis or a low-grade stenosis. In all eight patients who initially had a high-grade stenosis, the hepatic artery proved to be patent at 1 year. In 98% of patients, the anastomotic site of the portal vein did not change significantly. In one patient who initially had a normal anastomosis, occlusion was found at I year.

Conclusions: In most patients, routine angiography 2 months and 1 year after OLT demonstrated normal findings or a low-grade stenotic anastomosis of the hepatic artery and portal vein. Significant changes occurred mainly at the anastomotic site of the hepatic artery and could not be predicted by previous angiograms.

MeSH terms

  • Adult
  • Anastomosis, Surgical
  • Angiography
  • Child, Preschool
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / pathology
  • Female
  • Follow-Up Studies
  • Hepatic Artery / diagnostic imaging*
  • Hepatic Artery / pathology
  • Humans
  • Liver Transplantation / diagnostic imaging*
  • Male
  • Portal Vein / diagnostic imaging*
  • Portal Vein / pathology
  • Postoperative Complications / diagnostic imaging
  • Time Factors