Imaging Department, Bambino Gesù Children Hospital, Rome, Italy.
Radiol Med. 2016 May;121(5):378-90. doi: 10.1007/s11547-016-0628-3. Epub 2016 Feb 24.
Liver transplantation has become an established curative treatment in adult patients with acute or chronic end-stage liver diseases. In pediatric cases the number of cadaveric donor livers is not sufficient and to overcome the shortage of appropriate-sized whole liver grafts, technical variants of liver transplantation have been practiced. Reduced-size cadaveric and split cadaveric allografts have become an important therapeutic option, expanding the availability of size-appropriate organs for pediatric recipients with terminal liver disease. The number of pediatric deaths awaiting liver transplantation has been reduced by the introduction of living-related liver transplantation, developed to overcome the shortage of suitable grafts for children. It is important for radiologists to know that children have distinct imaging of liver transplantation that distinguish them from adults. A multidisciplinary pediatric liver transplantation team should be skilled in pediatric conditions and in associated processes, risks and complications. Radiologists should know the common pediatric liver diseases that lead to liver transplantation, the anastomotic techniques and the expected postoperative imaging findings. The aim of this study is to illustrate the role of non-invasive imaging such us ultrasonography, color Doppler ultrasonography, multidetector computed tomography and magnetic resonance imaging in the evaluation of pediatric liver transplantation and in potential liver donors.
肝移植已成为治疗成人急、慢性终末期肝病的一种成熟的治疗方法。在儿科病例中,尸体供肝的数量不足,为了克服合适大小全肝移植物的短缺,已经采用了肝移植的技术变体。减小体积的尸体供肝和劈裂的尸体供肝已成为重要的治疗选择,为患有终末期肝病的儿科受者提供了更多适合其体型的器官。通过引入活体相关肝移植,减少了等待肝移植的儿科患者死亡人数,活体相关肝移植的发展是为了克服儿童合适供体的短缺。放射科医生应该知道,儿童的肝移植影像学表现与成人不同。多学科儿科肝移植团队应该熟练掌握儿科疾病及其相关过程、风险和并发症。放射科医生应该了解导致肝移植的常见儿科疾病、吻合技术以及预期的术后影像学表现。本研究的目的是说明非侵入性影像学(如超声、彩色多普勒超声、多排螺旋 CT 和磁共振成像)在儿科肝移植和潜在肝供者评估中的作用。