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Yan Y, Chen Q, Dai X, Xiang Z, Long Z, Wu Y, Jiang H, Zou J, Wang M, Zhu Z. Amino acid metabolomics and machine learning for assessment of post-hepatectomy liver regeneration. Front Pharmacol 2024; 15:1345099. [PMID: 38855741 PMCID: PMC11157015 DOI: 10.3389/fphar.2024.1345099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/06/2024] [Indexed: 06/11/2024] Open
Abstract
Objective Amino acid (AA) metabolism plays a vital role in liver regeneration. However, its measuring utility for post-hepatectomy liver regeneration under different conditions remains unclear. We aimed to combine machine learning (ML) models with AA metabolomics to assess liver regeneration in health and non-alcoholic steatohepatitis (NASH). Methods The liver index (liver weight/body weight) was calculated following 70% hepatectomy in healthy and NASH mice. The serum levels of 39 amino acids were measured using ultra-high performance liquid chromatography-tandem mass spectrometry analysis. We used orthogonal partial least squares discriminant analysis to determine differential AAs and disturbed metabolic pathways during liver regeneration. The SHapley Additive exPlanations algorithm was performed to identify potential AA signatures, and five ML models including least absolute shrinkage and selection operator, random forest, K-nearest neighbor (KNN), support vector regression, and extreme gradient boosting were utilized to assess the liver index. Results Eleven and twenty-two differential AAs were identified in the healthy and NASH groups, respectively. Among these metabolites, arginine and proline metabolism were commonly disturbed metabolic pathways related to liver regeneration in both groups. Five AA signatures were identified, including hydroxylysine, L-serine, 3-methylhistidine, L-tyrosine, and homocitrulline in healthy group, and L-arginine, 2-aminobutyric acid, sarcosine, beta-alanine, and L-cysteine in NASH group. The KNN model demonstrated the best evaluation performance with mean absolute error, root mean square error, and coefficient of determination values of 0.0037, 0.0047, 0.79 and 0.0028, 0.0034, 0.71 for the healthy and NASH groups, respectively. Conclusion The KNN model based on five AA signatures performed best, which suggests that it may be a valuable tool for assessing post-hepatectomy liver regeneration in health and NASH.
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Affiliation(s)
- Yuqing Yan
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
- Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Qianping Chen
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
- Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaoming Dai
- The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Zhiqiang Xiang
- The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Zhangtao Long
- The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Yachen Wu
- The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Hui Jiang
- Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Jianjun Zou
- Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing, China
| | - Mu Wang
- The NanHua Affiliated Hospital, Clinical Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Zhu Zhu
- The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China
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Mervak BM, Roseland ME, Wasnik AP. Pancreatic Transplantation: Surgical Anatomy and Complications. Radiol Clin North Am 2023; 61:821-831. [PMID: 37495290 DOI: 10.1016/j.rcl.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Pancreatic transplantation is a complex surgical procedure performed for patients with chronic severe diabetes, often performed in combination with renal transplantation. Vascular and exocrine drainage anatomy varies depending on the surgical technique. Radiology plays a critical role in the diagnosis of postoperative complications, requiring an understanding of grayscale/Doppler ultrasound as well as computed tomography and MR imaging. In this review, we detail usual surgical methods and normal postoperative imaging appearances. We then review the most common complications following pancreatic transplants, emphasizing diagnostic features of vascular (arterial/venous), surgical, and diffuse parenchymal pathologic conditions on multiple imaging modalities.
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Affiliation(s)
- Benjamin M Mervak
- Division of Abdominal Radiology, Department of Radiology, University of Michigan-Michigan Medicine, University Hospital, B1D502, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Molly E Roseland
- Division of Abdominal Radiology, Department of Radiology, University of Michigan-Michigan Medicine, University Hospital, B1D502, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA; Division of Nuclear Medicine, Department of Radiology, University of Michigan-Michigan Medicine, University Hospital, B1D502, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Ashish P Wasnik
- Division of Abdominal Radiology, Department of Radiology, University of Michigan-Michigan Medicine, University Hospital, B1D502, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
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Sun R, Zhao H, Huang S, Zhang R, Lu Z, Li S, Wang G, Aa J, Xie Y. Prediction of Liver Weight Recovery by an Integrated Metabolomics and Machine Learning Approach After 2/3 Partial Hepatectomy. Front Pharmacol 2021; 12:760474. [PMID: 34916939 PMCID: PMC8669962 DOI: 10.3389/fphar.2021.760474] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/01/2021] [Indexed: 12/15/2022] Open
Abstract
Liver has an ability to regenerate itself in mammals, whereas the mechanism has not been fully explained. Here we used a GC/MS-based metabolomic method to profile the dynamic endogenous metabolic change in the serum of C57BL/6J mice at different times after 2/3 partial hepatectomy (PHx), and nine machine learning methods including Least Absolute Shrinkage and Selection Operator Regression (LASSO), Partial Least Squares Regression (PLS), Principal Components Regression (PCR), k-Nearest Neighbors (KNN), Support Vector Machines (SVM), Random Forest (RF), eXtreme Gradient Boosting (xgbDART), Neural Network (NNET) and Bayesian Regularized Neural Network (BRNN) were used for regression between the liver index and metabolomic data at different stages of liver regeneration. We found a tree-based random forest method that had the minimum average Mean Absolute Error (MAE), Root Mean Squared Error (RMSE) and the maximum R square (R2) and is time-saving. Furthermore, variable of importance in the project (VIP) analysis of RF method was performed and metabolites with VIP ranked top 20 were selected as the most critical metabolites contributing to the model. Ornithine, phenylalanine, 2-hydroxybutyric acid, lysine, etc. were chosen as the most important metabolites which had strong correlations with the liver index. Further pathway analysis found Arginine biosynthesis, Pantothenate and CoA biosynthesis, Galactose metabolism, Valine, leucine and isoleucine degradation were the most influenced pathways. In summary, several amino acid metabolic pathways and glucose metabolism pathway were dynamically changed during liver regeneration. The RF method showed advantages for predicting the liver index after PHx over other machine learning methods used and a metabolic clock containing four metabolites is established to predict the liver index during liver regeneration.
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Affiliation(s)
- Runbin Sun
- Jiangsu Province Key Laboratory of Drug Metabolism and Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China.,Phase I Clinical Trials Unit, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, China
| | - Haokai Zhao
- Jiangsu Province Key Laboratory of Drug Metabolism and Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China
| | - Shuzhen Huang
- Jiangsu Province Key Laboratory of Drug Metabolism and Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China
| | - Ran Zhang
- Jiangsu Province Key Laboratory of Drug Metabolism and Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China
| | - Zhenyao Lu
- Jiangsu Province Key Laboratory of Drug Metabolism and Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China
| | - Sijia Li
- Jiangsu Province Key Laboratory of Drug Metabolism and Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China
| | - Guangji Wang
- Jiangsu Province Key Laboratory of Drug Metabolism and Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China
| | - Jiye Aa
- Jiangsu Province Key Laboratory of Drug Metabolism and Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China
| | - Yuan Xie
- Jiangsu Province Key Laboratory of Drug Metabolism and Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China
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Yen LH, Sabatino JC. Imaging complications of liver transplantation: a multimodality pictorial review. Abdom Radiol (NY) 2021; 46:2444-2457. [PMID: 31679057 DOI: 10.1007/s00261-019-02270-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Liver transplantation is one of the most commonly performed surgical procedures for the treatment of end-stage liver disease and hepatocellular carcinoma. Post-transplantation complications include vascular, nonvascular, and biliary. Common imaging techniques used to evaluate the hepatic graft are ultrasonography (US), CT, MR imaging, cholangiography, angiography, and scintigraphy. The purposes of this pictorial review are to review imaging findings of complications of liver transplantation and provide a framework for early detection of post-surgical complications.
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Mohamed Afif A, Anthony APM, Jamaruddin S, Su'aidi SU, Li HH, Low ASC, Cheong EHT. Diagnostic accuracy of Doppler ultrasound for detecting hepatic artery stenosis after liver transplantation. Clin Radiol 2021; 76:708.e19-708.e25. [PMID: 33902885 DOI: 10.1016/j.crad.2021.02.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/17/2021] [Indexed: 12/25/2022]
Abstract
AIM To evaluate the diagnostic accuracy of Doppler ultrasound (DUS) in detecting hepatic artery stenosis (HAS) after liver transplantation using computed tomography angiography (CTA) as the reference standard. MATERIALS AND METHODS This study included data from January 2005 to November 2017, where DUS of the hepatic artery of living and deceased donor liver grafts were compared with the reference standard, CTA. DUS parameters, such as intrahepatic artery (IHA) peak systolic velocity (PSV), resistive index (RI), systolic acceleration time (SAT); and extrahepatic artery (EHA) PSV were taken. The optimum cut-off was estimated using area under the receiver operating characteristic curve (AUC). Multivariable logistic regression analysis was developed to predict HAS. RESULTS Ninety-nine liver transplant cases were retrieved, 50 met the inclusion criteria where nine patients had significant HAS. HAS patients had a significantly low IHAPSV with a cut-off of 35.1 cm/s (sensitivity 53.8%, specificity 78.4%, AUC 0.701). IHARI had a significantly low RI with a cut-off 0.585 (sensitivity 86.7%, specificity 85.4%, AUC 0.913). The IHASAT cut-off was 0.045 seconds (sensitivity 80%, specificity 91.4%, AUC 0.857). The EHAPSV cut-off was 197.4 cm/s (sensitivity 50%, specificity 99.1%, AUC 0.648). The prediction model using DUS parameters IHARI and IHASAT demonstrated good discrimination with an AUC of 0.930 (95% CI: 0.843, 1.000; sensitivity 93.3%, specificity 88%). CONCLUSION A prediction model using the DUS parameters IHARI and IHASAT showed good diagnostic accuracy of 88.6% for monitoring liver transplant patients. If validated externally, this DUS model could be utilised to diagnose HAS in liver transplant recipients.
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Affiliation(s)
- A Mohamed Afif
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
| | - A P M Anthony
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - S Jamaruddin
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - S U Su'aidi
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - H H Li
- Department of Health Serviced Research Unit, Singapore General Hospital, Singapore
| | - A S C Low
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - E H T Cheong
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
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Gad EH, Alsebaey A, Lotfy M, Eltabbakh M, Sherif AA. Complications and mortality after adult to adult living donor liver transplantation: A retrospective cohort study. Ann Med Surg (Lond) 2015. [DOI: https:/doi.org/10.1016/j.amsu.2015.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Gad EH, Alsebaey A, Lotfy M, Eltabbakh M, Sherif AA. Complications and mortality after adult to adult living donor liver transplantation: A retrospective cohort study. Ann Med Surg (Lond) 2015. [DOI: https://doi.org/10.1016/j.amsu.2015.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Gad EH, Alsebaey A, Lotfy M, Eltabbakh M, Sherif AA. Complications and mortality after adult to adult living donor liver transplantation: A retrospective cohort study. ANNALS OF MEDICINE AND SURGERY (2012) 2015. [PMID: 26005570 DOI: 10.1016/j.amsu.2015.04.021.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
BACKGROUND AND AIMS Living donor liver transplantation (LDLT) is widely performed for patients to resolve the critical shortage of organs from cadavers. Despite rapid implementation of the procedure, both complications and mortality of LDLT are annoying problems. The aim of this study was to analyze complications and mortality of patients after adult to adult LDLT (A-ALDLT) in a single center. METHODS Between April 2003 and November 2013, 167 (A-ALDLT) recipients in National Liver Institute, Egypt were included. We retrospectively analyzed complications and mortality in them. RESULTS The overall incidence of complications was 86.2% (n = 144) and classified as biliary 43.7% (n = 73), vascular 21.6% (n = 36), Small for size syndrome (SFSS) 12.6% (n = 21), Gastrointestinal tract (GIT) 19.8% (n = 33), wound 12.6% (n = 21), chest 19.8% (n = 33), neurological 26.3% (n = 44), renal 21% (n = 35), intra abdominal collection 21.6% (n = 36), recurrent hepatitis C virus (HCV) 16.8% (n = 28), recurrent hepatocellular carcinoma (HCC) 2.4% (n = 4), acute rejection 19.2% (n = 32). 65 (45.1%) of 144 complicated patients died, while 10 (43.5%) of 23 non complicated died. The incidence of whole, in hospital and late mortalities were 44.9%, 28.7% and 16.2% respectively. CONCLUSIONS Mortality was higher among complicated cases where vascular complications and SFSS had significant effect on it so prevention and treatment of them is required for improving outcome.
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Affiliation(s)
- Emad Hamdy Gad
- Hepatobiliary Surgery Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt
| | - Ayman Alsebaey
- Hepatology Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt
| | - Maha Lotfy
- Anesthesia Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt
| | - Mohamed Eltabbakh
- Hepatology Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt
| | - Ahmed Alshawadfy Sherif
- Hepatobiliary Surgery Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt
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Gad EH, Alsebaey A, Lotfy M, Eltabbakh M, Sherif AA. Complications and mortality after adult to adult living donor liver transplantation: A retrospective cohort study. Ann Med Surg (Lond) 2015; 4:162-71. [PMID: 26005570 PMCID: PMC4434206 DOI: 10.1016/j.amsu.2015.04.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/02/2015] [Accepted: 04/20/2015] [Indexed: 02/05/2023] Open
Abstract
Background and aims Living donor liver transplantation (LDLT) is widely performed for patients to resolve the critical shortage of organs from cadavers. Despite rapid implementation of the procedure, both complications and mortality of LDLT are annoying problems. The aim of this study was to analyze complications and mortality of patients after adult to adult LDLT (A-ALDLT) in a single center. Methods: Between April 2003 and November 2013, 167 (A-ALDLT) recipients in National Liver Institute, Egypt were included. We retrospectively analyzed complications and mortality in them. Results The overall incidence of complications was 86.2% (n = 144) and classified as biliary 43.7% (n = 73), vascular 21.6% (n = 36), Small for size syndrome (SFSS) 12.6% (n = 21), Gastrointestinal tract (GIT) 19.8% (n = 33), wound 12.6% (n = 21), chest 19.8% (n = 33), neurological 26.3% (n = 44), renal 21% (n = 35), intra abdominal collection 21.6% (n = 36), recurrent hepatitis C virus (HCV) 16.8% (n = 28), recurrent hepatocellular carcinoma (HCC) 2.4% (n = 4), acute rejection 19.2% (n = 32). 65 (45.1%) of 144 complicated patients died, while 10 (43.5%) of 23 non complicated died. The incidence of whole, in hospital and late mortalities were 44.9%, 28.7% and 16.2% respectively. Conclusions: Mortality was higher among complicated cases where vascular complications and SFSS had significant effect on it so prevention and treatment of them is required for improving outcome. Mortality was higher among complicated cases. Vascular complication was independent predictors of poor outcome. Small for size syndrome was independent predictors of poor outcome. Proper management of the previous complications improve outcome of LDLT.
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Affiliation(s)
- Emad Hamdy Gad
- Hepatobiliary Surgery Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt
| | - Ayman Alsebaey
- Hepatology Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt
| | - Maha Lotfy
- Anesthesia Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt
| | - Mohamed Eltabbakh
- Hepatology Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt
| | - Ahmed Alshawadfy Sherif
- Hepatobiliary Surgery Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt
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Meng XC, Huang WS, Xie PY, Chen XZ, Cai MY, Shan H, Zhu KS. Role of multi-detector computed tomography for biliary complications after liver transplantation. World J Gastroenterol 2014; 20:11856-11864. [PMID: 25206292 PMCID: PMC4155378 DOI: 10.3748/wjg.v20.i33.11856] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/29/2014] [Accepted: 05/26/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the diagnostic performance of multi-detector computed tomography (MDCT) in detecting biliary complications after orthotopic liver transplantation (OLT).
METHODS: Eighty-three consecutive OLT recipients, who presented with clinical or biochemical signs of biliary complications, underwent MDCT examination. Two experienced radiologists assessed MDCT images in consensus to determine biliary complications. Final confirmation was based on percutaneous transhepatic cholangiography or endoscopic retrograde cholangiography in 58 patients, surgery in four patients, liver biopsy in 10, and clinical and sonography follow-up in 11 patients.
RESULTS: Biliary complications were eventually confirmed in 62 of 83 patients (74.7%), including anastomotic biliary strictures in 32, nonanastomotic biliary strictures in 21, biliary stones in nine (5 with biliary strictures), anastomotic bile leak in five, and biloma in six (all with nonanastomotic strictures, and 2 with biligenic hepatic abscess). Twenty-one patients had no detection of biliary complications. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MDCT for detecting biliary strictures were 90.6%, 86.7%, 89.2%, 92.3% and 83.9%, respectively. For detecting biliary stones, anastomotic bile leak and biloma, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MDCT were all 100%.
CONCLUSION: MDCT is a useful screening tool for detecting biliary complications after OLT.
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Low G, Crockett AM, Leung K, Walji AH, Patel VH, Shapiro AMJ, Lomas DJ, Coulden RA. Imaging of vascular complications and their consequences following transplantation in the abdomen. Radiographics 2014; 33:633-52. [PMID: 23674767 DOI: 10.1148/rg.333125728] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Transplantation is the surgical treatment of choice for end-stage organ failure. Transplantation procedures performed in the abdomen include liver, renal, pancreas, islet, intestinal, and multivisceral transplantations. Imaging plays a pivotal role in the posttransplantation setting for monitoring the transplant allograft and screening for complications. Knowledge of the surgical techniques employed in abdominal transplantation is essential because it facilitates radiologic understanding and interpretation of the posttransplantation anatomy. This article includes a basic description of the standard surgical techniques performed in the abdomen, with emphasis on the relevant vascular anastomotic reconstructions used. Posttransplantation complications can be broadly classified as vascular or nonvascular in origin. Many of these complications can be accurately depicted and characterized at imaging and dealt with definitively by using interventional radiology techniques, which can be graft- and life-saving and can obviate further complex surgical intervention. The article discusses imaging appearances of vascular complications and their consequences after transplantation in the abdomen. These vascular complications include arterial thrombosis, arterial stenosis, venous thrombosis and stenosis, arteriovenous fistula formation, and pseudoaneurysm formation. The relevant predisposing factors, clinical features, imaging appearances, and potential treatment options for vascular complications of various types of transplantation are presented in a logical and integrated fashion. Knowledge and imaging recognition of the posttransplantation vascular complications discussed in this article will aid radiologists in accurate imaging characterization and thereby facilitate appropriate clinical management and therapy.
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Affiliation(s)
- Gavin Low
- Departments of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, Canada.
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Abdelaziz O, Samie AA, Metwally LI. Multi-slice computed tomography imaging of the post transplant complications in the recipients after living donor liver transplantation. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2013. [DOI: 10.1016/j.ejrnm.2013.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Dani G, Sun MR, Bennett AE. Imaging of Liver Transplant and its Complications. Semin Ultrasound CT MR 2013; 34:365-77. [DOI: 10.1053/j.sult.2013.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Elrakhawy MM, Eid NKE, Wahab MA, Mousa AE, Helmy EM. Multidetector CT in pre- and post-operative evaluation of living-related liver transplantation. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2013. [DOI: 10.1016/j.ejrnm.2013.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Role of magnetic resonance imaging in the detection of anastomotic biliary strictures after liver transplantation. Transplant Proc 2011; 43:1132-5. [PMID: 21620070 DOI: 10.1016/j.transproceed.2011.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Biliary complications after orthotopic liver transplantation (OLT) are the principal cause of morbidity and graft dysfunction, ranging in incidence from 5.8% to 30% of cases. Biliary strictures are the most frequent type of late complication. The aim of this study was to evaluate the role of magnetic resonance cholangiography (MRC) to detect biliary anastomotic strictures among patients undergone OLT with abnormal liver function tests. MATERIALS AND METHODS One hundred twenty-one of 300 patients who underwent OLT were evaluated by MRC for clinically suspected anastomotic biliary strictures. In all patients, we performed various precholangiographic sequences including T1- and T2-weighted and MRC (radial SE 2D and SS-TSE 3D). Magnetic resonance imaging findings were subdivided as absence or presence of an anastomotic stricture. Diagnostic confirmation was obtained by endoscopic retrograde cholangiography (n=32), percutaneous transhepatic cholangiography (n=21) or surgical treatment (n=18). RESULTS MRC detected 56 anastomotic biliary strictures, 53 of which were confirmed by other imaging modalities. MRC showed two false-negative cases and three false-positive cases. The sensitivity, specificity, positive and negative predictive values, and accuracy of MRC to detect biliary strictures were 96%, 96%, 95%, 97%, and 96%, respectively. CONCLUSION MRC proved to be a reliable noninvasive technique to visualize the biliary anastomosis and depict biliary strictures after OLT. MRC should be used when a biliary anastomotic stricture is suspected in an OLT patient.
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Ersoy H. The role of noninvasive vascular imaging in splanchnic and mesenteric pathology. Clin Gastroenterol Hepatol 2009; 7:270-8. [PMID: 19201388 DOI: 10.1016/j.cgh.2008.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Revised: 12/03/2008] [Accepted: 12/05/2008] [Indexed: 02/07/2023]
Abstract
Traditionally, catheter angiography (CA) has been the mainstay of diagnosis for mesenteric arterial diseases. However, CA is invasive and is associated with complications that result from the procedure itself, depending on the experience of the operators, site of vascular access, ionized radiation that could be significant when combined with interventional procedures, and administered contrast material. During the past 2 decades, technical improvements in computed tomography (CT) and magnetic resonance hardware and methods have contributed new, noninvasive tools, specifically CT angiography (CTA) and 3-dimensional gadolinium-enhanced magnetic resonance angiography (3D Gd-MRA). This article outlines the current applications, strengths, and weaknesses of CTA and 3D Gd-MRA in imaging of the mesenteric vessels.
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Affiliation(s)
- Hale Ersoy
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
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