Evaluation in Liver Transplantation

Imaging proof of a patent portal vein is required in order for a patient to be placed on the liver transplant waiting list. Ultrasound (US) can image the portal vein, but is not 100% reliable.When US fails to adequately visualize the portal vein, 3D CE MRA offers a safe, accurate, and comprehensive assessment of portal-venous anatomy without requiring iodinated contrast medium [10,12]. 3D CE MRA is also able to evaluate the splenic vein, SMV, IMV, inferior caval vein (ICV) and potential varices. Following liver transplantation, rising liver function tests may raise a suspicion of allograft ischemia. Since blood supply to the liver occurs primarily via the portal vein, this is the most important vessel to evaluate. The most common site of obstruction is at the anastomosis. Usually, anastomoses are easy to identify because of the caliber change between donor and recipient portal veins [23]. Stenosis of the transplant arterial anastomosis may be seen on the arterial phase of a portal-venous study, but its smaller size and often folded, tortuous course can make it difficult to assess. Occlusion of the transplant artery is important to detect because it results in ischemia to the donor common bile duct and can lead to biliary strictures and leaks. It is also important to assess the ICV since supra- and in-frahepatic ICV anastomoses may also become narrowed and flow limiting.

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Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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