Injuries of adjacent organs by the expanded polytetrafluoroethylene grafts in the venoplasty of middle hepatic veins in living-donor liver transplantation: Computed tomographic findings and possible risk factors

Objective: The objective of the study was to analyze computed tomography (CT) appearance and clinical features of adjacent-organ injuries related to expanded polytetrafluoroethylene (ePTFE) grafts after living-donor liver transplantation (LDLT). Methods: We evaluated follow-up CT images of 204 patients who underwent venoplasty with ePTFE during LDLT and encountered 4 patients (1.96%) with adjacent-organ injuries related to ePTFE. Clinical imaging records were reviewed in terms of imaging findings and possible risk factors. Results: In 3 patients, ePTFE graft perforated gastric antrum or duodenal bulb; in another patient, the common bile duct was injured. The mean interval between transplantation and identification of injury was 30 months. In patients with adjacent-organ injuries, biliary or perihepatic interventional treatments, adhesion of bowel and early occlusion of ePTFE grafts were commonly observed. Conclusions: Adjacent-organ injuries by ePTFE graft after LDLT were rare but present. Interventional procedures, adhesion of the bowel wall and early occlusion of the grafts were possible risk factors.