Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Renal Safety of Intravenous Gadolinium-enhanced MRI in Patients Following Liver Transplantation

Flynn, Mary M.1; Parekh, Anjali N.1; Parikh, Mehul R.1; Sood, Akhil1; Shaffer, Katherine M.1; Runge, Thomas M.2; Lipowska, Anna M.1; Perez, Sebastian D.; Sakaria, Sonali S.1; Subramanian, Ram M.1,2

doi: 10.1097/TP.0000000000002678
Original Clinical Science—Liver
Buy

Background. Intravenous contrast-enhanced imaging is invaluable in diagnosing pathology following liver transplantation. Given the potential risk of contrast nephropathy associated with iodinated computed tomography contrast, alternate contrast modalities need to be examined, especially in the setting of renal insufficiency. The purpose of this study was to examine the renal safety of MRI with gadolinium following liver transplantation.

Methods. The study involved a retrospective analysis of 549 cases of abdominal MRI with low-dose gadobenate dimeglumine in liver transplant recipients at a single center. For each case, serum creatinine values before and after the MRI were compared. In addition, cases were analyzed for the development of nephrogenic systemic fibrosis.

Results. Pre-MRI creatinine values ranged from 0.32 to 6.57 mg/dL (median, 1.28 g/dL), with 191 cases having values ≥1.5 mg/dL (median, 1.86 g/dL). A comparison of the pre- and post-MRI creatinine values showed no significant difference, including those patients with pre-MRI values ≥1.5 mg/dL (mean change of −0.04 [95% confidence interval, −0.07 to −0.01; P = 0.004]). No cases of nephrogenic systemic fibrosis were noted.

Conclusions. Our findings suggest that, irrespective of baseline renal function, MRI with gadobenate dimeglumine is a nonnephrotoxic imaging modality in liver transplant recipients. Importantly, this intravenous contrast-enhanced imaging modality can be considered in those posttransplant patients who have a contraindication to computed tomography contrast due to renal insufficiency.

1 Department of Medicine, Emory University School of Medicine, Atlanta, GA.

2 Department of Surgery, Emory University School of Medicine, Atlanta, GA.

Received 13 June 2018. Revision received 31 January 2019.

Accepted 6 February 2019.

The authors declare no conflicts of interest.

M.M.F. participated in study design, data analysis, and writing of the paper. A.N.P. participated in data collection and writing of the paper. M.R.P. participated in study design, data collection, and writing of the paper. A.S. participated in data collection and writing of the paper. K.M.S. participated in study design, data collection, and writing of the paper. T.M.R. participated in study design, data collection, and writing of the paper. A.M.L. participated in study design, data collection, and writing of the paper. S.D.P. participated in data analysis. S.S.S. participated in study design, data collection, and writing of the paper. R.M.S. participated in research design, data analysis, and writing of the paper.

Correspondence: Ram M. Subramanian, MD, Departments of Medicine & Surgery, Emory University School of Medicine, 1365 Clifton Road, NE, B 6100, Atlanta, GA 30322, USA. (rmsubra@emory.edu).

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.