Utilidad de las modalidades imaginológicas en complicaciones vasculares arteriales del trasplante hepático

Objetivo. Revisar las complicaciones arteriales post-trasplante hepatico, su diagnostico y tratamiento mediante abordaje multimodal de imagenes, en la Policlinica Metropolitana. Pacientes y Metodos. Se incluyeron los 49 trasplantados hepaticos entre abril 2005 y diciembre 2009. De haber alteraciones clinicas o en el flujo doppler arterial, se realizo angiotomografia, y de confirmar la alteracion, se realizo tratamiento endovascular. Resultados. El Doppler mostro flujo arterial anormal en 4 pacientes. Otros dos no mostraron anomalia en doppler, sino en la quimica sanguinea. La angiotomografia arterial hepatica revelo estenosis en cinco pacientes y trombosis en uno. El tratamiento endovascular permitio recuperar el flujo en todos. La sensibilidad y especificidad del Doppler para el diagnostico de las complicaciones arteriales post-trasplante hepatico fueron de 100% y 95,5 %, respectivamente, y para la tomografia, de 100% para ambos. Conclusion. Proponemos que solo aquellos pacientes con complicacion arterial hepatica demostrada mediante angiotomografia, sean llevados a procedimiento endovascular. Title Utility of multimodal imaging in arterial complications of hepatic transplantation Abstract Objective. To review the postoperatory arterial complications after hepatic transplantation, and its diagnosis and treatment through multimodal imaging approach, at the Policlinica Metropolitana. Patients and Methods. 49 hepatic trasplant recipients were included between april 2005 and december 2009. If clinical or arterial flow alterations in doppler were found, an angiotomographic study was carried out, and if the alteration was confirmed, endovascular treatment was performed. Results. Post-transplant Doppler revealed abnormal arterial flow in 4 patients. Another two patients did not show abnormalities in doppler, but in the blood biochemistry. Arterial angiotomography demonstrated stenosis in five patients, and thrombosis in one. Endovascular treatment achieved flow recovery in all cases. Doppler sensibility and specificity in the diagnosis of hepatic post-transplantation arterial complications, were 100% and 95,5 %, respectively, and for angiotomography was 100% for both. Conclusion. We propose that only those patients, with hepatic arterial complication, angiotomographically demostrated, are candidates for endovascular therapeutic procedures.