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Interventional radiology in liver transplantation

Radiology Department, Royal Free Hospital, London, UK

• The role of interventional radiology in the routine evaluation of patients for liver transplantation has reduced as cross-sectional imaging techniques have improved.
  
• A detailed knowledge of the surgical technique employed at transplantation is essential when considering any subsequent intervention.
  
• Hepatic vein studies and transjugular liver biopsy are simple, safe and effective techniques both pre and post transplantation.
  
• The transjugular intrahepatic portosystemic shunt (TIPS) procedure is a very effective pre-transplantation technique in selected patients, including those with Budd–Chiari syndrome and portal venous thrombosis.
  
• A variety of interventional radiological techniques are available to treat hepatocellular carcinoma, but their use in the liver transplant setting have not been validated by controlled studies.
  
• Vascular complications occurring in the early post-transplant period are emergencies that require prompt detection and treatment. Hepatic artery thrombosis is the most common vascular complication and usually requires re-transplantation.
  
• Biliary strictures are important cause of morbidity and are frequently due to ischaemia.
  

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