Contrast-enhanced multidetector-CT cholangiography after living donor liver transplantation.

BACKGROUND/AIMS: To prospectively evaluate the feasibility of postoperative contrast enhanced Multi-detector-CT cholangiography (ceMDCT-CA) in living liver donors and transplant recipients.

METHODOLOGY

Fifteen donors and 11 recipients of a right hepatic lobe underwent ceMDCT-CA. Six donors were admitted to exclude biliary leakage; 9 donors and 11 recipients were examined to exclude postoperative biliary obstruction. The examination protocol included the intravenous short-infusion of 100 mL of a biliary contrast agent. CT cholangiography data was acquired with a slice thickness of 1 mm. This scan was followed by examination of the upper abdomen in a venous phase. Data sets were evaluated quantitatively by measurement of the biliary opacification, and qualitatively on the basis of a scale ranging from 1 (non-diagnostic) to 4 (excellent). Opacification was correlated with postoperative serum bilirubin level.

RESULTS

CT data provided diagnostic delineation of the biliary tree in all 15 donors and seven of 11 recipients; in 4 recipients the degree of biliary opacification was non-diagnostic. Biliary opacification was generally higher in the donor collective. Four donors and 3 recipients presented a moderate focal biliary constriction without elevation of laboratory values. Six patients showed postoperative fluid collections suggestive of perihepatic biloma, however no biliary fistula could be visualized.

CONCLUSIONS

CeMDCT-CA represents a promising tool to non-invasively assess the postoperative biliary morphology in living liver donors and transplant recipients.