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European Radiology
Published in: European Radiology 6/2018

01-06-2018 | Hepatobiliary-Pancreas

Computed tomography findings in ABO-incompatible living donor liver transplantation recipients with biliary strictures

Authors: Sang Hyun Choi, Kyoung Won Kim, So Yeon Kim, Jin Sil Kim, Jae Hyun Kwon, Gi-Won Song, Sung-Gyu Lee

Published in: European Radiology | Issue 6/2018

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Abstract

Objectives

To evaluate CT findings of biliary strictures in ABO-incompatible living donor liver transplantation (LDLT) recipients, with emphasis on associated 1-month post-transplantation CT findings, and evaluate clinical outcomes.

Methods

Of 351 ABO-incompatible recipients, we retrospectively evaluated CT scans in 65 recipients with biliary stricture. The biliary strictures on CT scans were classified as type A (perihilar) and type B (diffuse). Precedent CT abnormality patterns and the presence of a periportal halo sign at 1-month post-transplantation were evaluated. For each patient, clinical outcomes were evaluated.

Results

Of 65 ABO-incompatible recipients with biliary strictures, 36.9% had type B strictures. Compared with biliary strictures at diagnosis, similar CT abnormality patterns were observed for 84.4% in type A and 86.4% in type B strictures at 1-month post-transplantation. Complex periportal halo signs on the 1-month post-transplantation CT were more frequently noted for type B than type A strictures (86.4% vs. 3.1%, P < 0.001). Progressive clinical outcomes were more frequently observed for type B than type A strictures (79.2% vs. 26.8%, P < 0.001), with a significantly shorter graft survival time (46.4 months vs. 90.8 months, P < 0.001).

Conclusion

CT abnormality patterns and complex periportal halo signs on 1-month post-transplantation CT may be clinically useful for managing biliary strictures in ABO-incompatible LDLT recipients.
Key Points
• Of ABO-incompatible LDLT recipients, type B biliary stricture incidence was 6.8%.
• Of type B strictures, 86.4% exhibited similar CT abnormality patterns at 1-month post-transplantation.
• Complex periportal halo at 1 month was significantly associated with type B strictures.
• Progressive clinical outcomes were more frequently observed in type B strictures.
Appendix
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Metadata
Title
Computed tomography findings in ABO-incompatible living donor liver transplantation recipients with biliary strictures
Authors
Sang Hyun Choi
Kyoung Won Kim
So Yeon Kim
Jin Sil Kim
Jae Hyun Kwon
Gi-Won Song
Sung-Gyu Lee
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5226-9

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