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Injuries of Adjacent Organs by the Expanded Polytetrafluoroethylene Grafts in the Venoplasty of Middle Hepatic Veins in Living-Donor Liver Transplantation: Computed Tomographic Findings and Possible Risk Factors

Kim, Min Ju MD; Kim, Hyun Beom MD, PhD; Han, Joon Koo MD, PhD; Suh, Kyung-Suk MD, PhD; Kim, Seong Hoon MD, PhD; Baek, Jee Hyun MD; So, Young Ho MD; Byun, Jae Young MD, PhD; Kim, Dong Goo MD, PhD; Choi, Joon-Il MD, PhD

Journal of Computer Assisted Tomography: September/October 2011 - Volume 35 - Issue 5 - pp 544-548
doi: 10.1097/RCT.0b013e318227a68a
Abdominal Imaging

Objective: The objective of the study was to analyze computed tomography (CT) appearance and clinical features of adjacent-organ injuries related to expanded polytetrafluoroethylene (ePTFE) grafts after living-donor liver transplantation (LDLT).

Methods: We evaluated follow-up CT images of 204 patients who underwent venoplasty with ePTFE during LDLT and encountered 4 patients (1.96%) with adjacent-organ injuries related to ePTFE. Clinical imaging records were reviewed in terms of imaging findings and possible risk factors.

Results: In 3 patients, ePTFE graft perforated gastric antrum or duodenal bulb; in another patient, the common bile duct was injured. The mean interval between transplantation and identification of injury was 30 months. In patients with adjacent-organ injuries, biliary or perihepatic interventional treatments, adhesion of bowel and early occlusion of ePTFE grafts were commonly observed.

Conclusions: Adjacent-organ injuries by ePTFE graft after LDLT were rare but present. Interventional procedures, adhesion of the bowel wall and early occlusion of the grafts were possible risk factors.

From the *Department of Radiology and †Center for Liver Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si; ‡Department of Radiology and Institute of Radiation Medicine and §Department of Surgery, Seoul National University College of Medicine; ∥Department of Radiology, Seoul Metropolitan Government/Seoul National University Boramae Medical Center; and Departments of ¶Radiology and #Surgery, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.

Received for publication March 7, 2011; accepted June 3, 2011.

Reprints: Joon-Il Choi, MD, PhD, Department of Radiology, Seoul St Mary's Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, 137-701, Seoul, Republic of Korea (e-mail: dumkycji@gmail.com).

The authors report no conflicts of interest.

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.