Late Biliary Complications in Right Lobe Living Donor Transplantation Recipients: Imaging Findings and Therapeutic Interventions

PURPOSE: The purpose of this work was to present the imaging findings of late biliary complications in right lobe living donor liver transplantation recipients and to describe radiologic techniques used to treat these complications. METHOD: A retrospective review of medical records and imaging examinations was conducted in 5 of 48 right lobe living donor recipients with known biliary obstruction treated with percutaneous biliary drainage (PBD). Two abdominal radiologists reviewed in consensus the MR cholangiopancreatography (MRCP)/MR, ultrasound (US), CT, and PBD images. RESULTS: Biliary-enteric anastomotic strictures were detected in all five recipients. In the four recipients who underwent the procedure, MRCP detected obstruction in each. CT detected obstruction in the fifth recipient. US failed to detect obstruction in one of two recipients. PBD catheters were placed without complication and relieved the obstruction in all five recipients. In addition, in three recipients, balloon dilatation of the stricture was performed and resulted in anastomotic patency. CONCLUSION: Biliary-enteric anastomotic strictures accounted for all late biliary complications and were detected correctly with MRCP and CT. The strictures were treated successfully with PBD in all instances and balloon dilatation when possible.