Imaging findings of en bloc simultaneous liver-kidney transplantation
- PDF / 3,603,948 Bytes
- 15 Pages / 595.276 x 790.866 pts Page_size
- 62 Downloads / 213 Views
REVIEW
Imaging findings of en bloc simultaneous liver‑kidney transplantation Shaun A. Wahab1 · Bradley Abraham1 · Amanda Bailey2 · Kyuran Ann Choe1 Received: 13 August 2020 / Revised: 1 October 2020 / Accepted: 10 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Simultaneous liver-kidney transplantations (SLKTs) are increasing in incidence, and the en bloc surgical approach is associated with a unique spectrum of vascular complications. En bloc SLKTs have a common arterial supply from the celiac axis and post-operative assessment with Doppler ultrasound can help to localize vascular lesions as either proximal in the shared arterial supply or distal in the organ-specific arteries. Venous complications predominantly include thrombosis or stenosis of the portal vein, hepatic veins, renal vein, or IVC, but have a much lower incidence. Radiologists familiar with the postoperative anatomy and complications can provide meaningful and accurate assessment to help direct clinical care. The purpose of this article is to provide a targeted review of SLKT, review the post-surgical anatomy associated with en bloc SLKT, and review the imaging evaluation of vascular complications associated with SLKT. Keywords Liver transplantation · Kidney transplantation · Ultrasonography · Doppler
Introduction Patients with end-stage liver disease (ESLD) and end-stage renal disease (ESRD) can benefit from both liver and kidney transplants. Simultaneous liver-kidney transplantation (SLKT) refers to transplantation of both organs from the same donor. SLKT has been growing in incidence since the introduction of the Model for End-Stage Liver Disease (MELD) score in 2002 [1]. The MELD score uses patient creatinine, and thus renal function, as one of the four laboratory criteria for determining the severity of liver dysfunction. Since patients with more severe liver dysfunction get prioritized for liver transplantation, it is not unexpected that * Shaun A. Wahab [email protected] Bradley Abraham [email protected] Amanda Bailey [email protected] Kyuran Ann Choe [email protected] 1
Department of Radiology, University of Cincinnati, 234 Goodman St, ML 761, Cincinnati, OH 45267‑0761, USA
Department of Surgery, University of Cincinnati, Medical Sciences Building, 231 Albert Sabin Way, Cincinnati, OH 45267, USA
2
a large proportion of transplant recipients have concomitant severe renal dysfunction [2, 3]. There remains controversy on if SLKT provides additional benefits over liver alone transplantation. However, Singal et al. showed that there is evidence of improved 5-year survival with SLKT versus liver transplant alone in patients with a MELD score > 43 or a MELD score
Data Loading...
