Artery variations increase complication risk in liver transplants

December 02, 2004

3D MDCT angiography is a more efficient way to classify liver arterial anatomy before liver surgery, according to researchers from Duke University in Durham, NC.

In the study, 43 patients were evaluated before using 3D MDCT angiography. In 40 of 43 patients, surgical findings concurred with MDCT findings, indicating that 3D MDCT is an accurate method for imaging liver arteries prior to surgery, said Erik K. Paulson, MD, an author on the paper.

"Previously, patients underwent catheter angiography, diagnostic CT and sometimes an MRI as well. Now, all the relevant imaging issues can be addressed in one noninvasive test," said Dr. Paulson "This saves cost, reduces risk to the patient and saves time," he said.

In a separate study, University of Iowa researchers have found that using MR angiography before a liver transplant can help identify which patients will suffer complications.

The study found that if the liver artery anatomy is unusual, there is an increased risk of complications after the transplant procedure, said Kousei Ishigami, MD, lead author of the paper. The study analyzed 84 patients who underwent the imaging prior to liver transplantation. Of the sixty patients who had normal artery anatomy, only two had complications after surgery, whereas five of the 24 with variant anatomy experienced complications after surgery.

According to the authors of the study, having such a variant anatomy, which occurs during fetal development, usually does not affect a healthy person. However, the knowledge can be of great help for some liver transplant recipients. "If we know a transplant recipient has a variant liver artery, we need to carefully follow these patients after liver transplantation. Some transplant surgeons may also want to know the recipient's liver arterial anatomy before transplantation since knowledge of it may change the surgeon's technique or plan," said Dr. Ishigami, now at Kyushu University in Japan. "It should be noted, though, that MR angiography is impractical in emergency situations or when a patient is unable to remain still or hold their breath for the exam," he added.

Both studies appear in the December 2004 issue of the American Journal of Roentgenology.
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PDFs of both studies are available upon request to reporters.

American College of Radiology

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