Post-operative assessment in patients after liver transplantation: imaging parameters associated with 1-year graft failu
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COMPUTED TOMOGRAPHY
Post-operative assessment in patients after liver transplantation: imaging parameters associated with 1-year graft failure Wei-Chou Chang 1 & Benjamin M. Yeh 2 & Lisa Chu 3 & So Yeon Kim 4 & Kwun Wah Wen 5 & Sung-Hua Chiu 1 & Chien-Kuang Cornelia Ding 5 & En-Haw Wu 6 & John P. Roberts 7 & Guo-Shu Huang 1 & Hsian-He Hsu 1 Received: 13 April 2020 / Revised: 8 June 2020 / Accepted: 30 July 2020 # European Society of Radiology 2020
Abstract Purpose To identify post-liver transplant CT findings which predict graft failure within 1 year. Materials and methods We evaluated the CT scans of 202 adult liver transplants performed in our institution who underwent CT within 3 months after transplantation. We recorded CT findings of liver perfusion defect (LPD), parenchymal homogeneity, and the diameters and attenuations of the hepatic vessels. Findings were correlated to 1-year graft failure, and interobserver variability was assessed. Results Forty-one (20.3%) of the 202 liver grafts failed within 1 year. Graft failure was highly associated with LPD (n = 18/25, or 67%, versus 15/98, or 15%, p < 0.001), parenchymal hypoattenuation (n = 20/41, or 48.8% versus 17/161, or 10.6%, p < 0.001), and smaller diameter of portal veins (right portal vein [RPV], 10.7 ± 2.7 mm versus 14.7 ± 2.2 mm, and left portal vein [LPV], 9.8 ± 3.0 mm versus 12.4 ± 2.2 mm, p < 0.001, respectively). Of these findings, LPD (hazard ratio [HR], 5.43, p < 0.001) and small portal vein diameters (HR, RPV, 3.33, p < 0.001, and LPV, 3.13, p < 0.05) independently predicted graft failure. All the measurements showed fair to moderate interobserver agreement (0.233~0.597). Conclusion For patients who have CT scan within the first 3 months of liver transplantation, findings of LPD and small portal vein diameters predict 1-year graft failure. Key Points • Failed grafts are highly associated with liver perfusion defect, hypoattenuation, and small portal vein. • Right portal vein < 11.5 mm and left portal vein < 10.0 mm were associated with poor graft outcome. • Liver perfusion defect and small portal vein diameter independently predicted graft failure. Keywords Liver transplantation . Graft rejection . Tomography, X-ray computed . Portal vein . Perfusion
Abbreviations AUC Areas under the curve CCC Concordance correlation coefficient
CI HR HV
Confidence interval Hazard ratio Hepatic vein
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-07124-w) contains supplementary material, which is available to authorized users. * Wei-Chou Chang [email protected]
4
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
1
Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, People’s Republic of China
5
Department of Pathology, University of California San Francisco, San Francisco, CA, USA
2
Department of Radiology and Biomedical Imaging, University of
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