Computed tomography (CT) findings of liver perfusion defect (LPD) and small diameter of portal veins within the first 3 months after liver transplantation predict 1-year graft failure, researchers reported here on March 2 at the 2017 Annual European Congress of Radiology (ECR).

Graft failure is the main cause of re-transplantation and early death following liver transplantation. Persistent graft dysfunction occurring in the early postoperative period, to a lesser extent, may relate to ischemia-reperfusion injury to the allograft, with clinical and radiographic features that suggest hepatic vascular ischaemia.

Ultrasound with Doppler assessment of the hepatic artery, portal vein, and hepatic vein is frequently done to evaluate for post-transplantation complications; however, ultrasound results may be operator- dependent and limited by acoustic windows and overlying bowel gas.

Though CT is commonly used to evaluate anatomic postsurgical complications, the prognostic value of specific CT findings after liver transplantation has not been described.

For the current study, Tang Zun-Cheng, MD, Taipei City Hospital, Taipei, Taiwan, and colleagues reviewed all CT scans obtained in a series of adult patients within the first 3 months after liver transplantation. The analysis included 198 consecutive adult patients who underwent 202 liver transplantations.

Graft failure was defined as non-recoverable graft dysfunction requiring urgent re-transplantation or patient death within 1 year after liver transplantation. The graft failure group included 41 grafts that failed within 1 year after liver transplantation, while the successful graft group included the remaining 161 grafts that did not fail within 1 year.

Contrast-enhanced CT scans performed within the first 3 months after transplantation showed that a LPD was more frequent in patients with graft failure (18/25 [67%]) than patients with successful grafts (15/98 [15%]; P < .001).

Smaller diameter of portal veins was observed more frequently in the graft failure group than those in the successful graft group (right portal vein, 10.7 ± 2.7 mm vs 14.7 ± 2.2 mm; left portal vein, 9.8 ± 3.0 mm vs 12.4 ± 2.2 mm).

Further analysis showed that LPD (P < .05) and small portal veins diameter (P < .01) were the most significant independent predictors for graft failure within 3 months.

The European Congress of Radiology is sponsored by the European Society for Radiology.

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