IMAGING IN PEDIATRIC LIVER-TRANSPLANTATION

Liver transplantation is an accepted and successful mode of treatment for pediatric end-stage liver disease. On the basis of a review of 229 liver transplantations in 185 children, the authors describe the imag ing findings of the preoperative evaluation, the uncomplicated transpl antation, various postoperative complications, and the suggested percu taneous treatment of some of these complications. The most frequent in dications for liver transplantation encountered in this review were bi liary atresia (52%), acute fulminant hepatic failure (11%), alpha1-ant itrypsin deficiency (9%), cryptogenic cirrhosis (6%), and chronic acti ve hepatitis (4%). (The remaining 18% were various rare indications, r epresenting < 4% each.) Routine Doppler ultrasound is the modality of choice for the screening of postoperative complications, supplemented with computed tomography, hepatobiliary scintigraphy, and cholangiogra phy or angiography as needed. Familiarity with the normal graft appear ance, as influenced by various surgical and technical factors, and kno wledge of the underlying condition of the patient and the clinical cou rse of postoperative complications are crucial for a correct interpret ation of the findings from imaging studies.