3DCT angiography for detection of vascular complications in pediatric liver transplantation

Yu Fan Cheng*, Chao Long Chen, Tung Liang Huang, Tai Yi Chen, Yaw Sen Chen, Chih Chi Wang, Leo Leung Chit Tsang, King Wah Chiu, Bruno Jawan, Hock Liew Eng

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

29 Scopus citations

Abstract

Catheter angiography for early diagnosis of vascular complications in pediatric liver transplant yields excellent results but remains an extremely invasive examination for younger children, precluding its routine use. We assessed the efficacy of three-dimensional multislice computed tomographic angiography (3DCTA) as an alternative option in these patients. Methods. Twenty children suspected of vascular complications on clinical grounds, laboratory findings, or Doppler ultrasound underwent 3DCTA between April 2000 and April 2003. Interventional procedures via conventional angiography were subsequently performed in 5 cases, thrombolytic therapy in 4, surgical in 1, and conservative treatment in 10. Results. Two hepatic artery stenosis,1 hepatic artery thrombosis, 5 hepatic vein stenosis, 4 portal vein occlusion, 1 portal vein stenosis, and 7 non-vascular lesions were detected, all of which paralleled the findings of catheter angiography, Doppler ultrasound, and operations. The diagnostic accuracy for vascular complication was 90%. The sensitivity and specificity were 86.7% and 100%, respectively. The positive and negative predictive values were 100% and 71.4%, respectively. To date 19 patients are alive, with a median follow-up period of 24.8 months. In conclusion, 3DCTA is accurate and efficient in the identification of pathological vascular insults and offers essential information for major decision on further management of the vascular complications in pediatric recipients of liver transplant.

Original languageEnglish
Pages (from-to)248-252
Number of pages5
JournalLiver Transplantation
Volume10
Issue number2
DOIs
StatePublished - 02 2004
Externally publishedYes

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