ROLE OF DIFFERENT IMAGING MODALITIES IN ASSESSMENT OF PATIENTS UNDERGOING HEPATIC TRANSPLANTATION

Abstract

Liver transplantation has become the treatment of choice for end stage liver disease. With improved transplantation technology in the last years and new immunosuppressive agents the survival rates for the grafts are notably increased. Understanding the anatomy of liver and biliary system and the pathology of the diseases -which affecting them and require liver transplantation is of appreciable value for their evaluation by different preoperative radiological modalities. The main objectives of preoperative radiologic evaluation include (l) assessment of vessel patency for surgical planning, (2) quantification of diseased liver & presumed liver graft volume, (3) identification of cirrhosis and sequelae of portal hypertension, and (4) search for intrahepatic and extrahepatic malignancy. A basic understanding of the surgical techniques commonly used for liver transplantation is important in order to recognize complications and to direct further imaging or intervention. The most frequent complications of liver transplantation include : • Vascular complications: thrombosis or stenosis. • Biliary complications : obstruction or leak. • Rejection : acute or chronic. • Primary nonfunction of the transplanted liver. • Malignancy after transplantation. • Other postoperative abdominal complications. • Chest complications. • Neurologic complications. • Infection which include recurrent hepatitis BorC. Early diagnosis of complications may lead to therapeutic intervention that prolong the life of the graft.