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Spleen stiffness measurements by acoustic radiation force impulse imaging after living donor liver transplantation in children: a potential quantitative index for venous complications

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Abstract

Background

Living donor liver transplantation in children often results in venous complications, leading to portal hypertension. Spleen stiffness measurements have been recently proposed as a new, noninvasive parameter for portal hypertension in cirrhotic patients.

Objective

To evaluate the diagnostic value of spleen stiffness measurements by acoustic radiation force impulse (ARFI) imaging in diagnosing venous complications after pediatric living donor liver transplantation.

Materials and methods

We prospectively enrolled 69 patients after pediatric living donor liver transplantation using a left-side liver allograft. Around the time of the protocol liver biopsy examination, spleen stiffness measurements by ARFI imaging were performed via the left intercostal space at the center of the spleen parenchyma and repeated five times. Imaging examinations around the time of the spleen stiffness measurements were retrospectively reviewed. Regarding venous complications, significant portal and hepatic venous stenosis was defined as >50% stenosis on multiphasic computed tomography.

Results

After post hoc exclusion, 62 patients were studied. Portal and hepatic venous stenosis was identified in three and two patients, respectively. The median spleen stiffness values were 2.70 and 4.00 m/s in patients without and with venous complications, respectively (P < 0.001). Spleen stiffness measurements showed good diagnostic power for venous complications, and the cutoff value was determined as 2.93 m/s, with 100% sensitivity and 78.9% specificity. Spleen stiffness measurements decreased with the relief of venous stenosis resulting from an interventional radiology procedure.

Conclusion

Spleen stiffness measurements by ARFI imaging might provide a useful quantitative index for venous complications after pediatric living donor liver transplantation.

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Acknowledgments

The research presented in this manuscript was supported by the Japan Society for the Promotion of Science (JSPS KAKENHI, Grant-in-Aid for Young Scientists [B], Grant Number 26870570), and the authors have no conflicts of interest to disclose. The authors thank Mieko Tsuchida, Yuko Shirahata, Yoshiko Shiomi, Chigusa Mochizuki, Dr. Akihisa Ueno and Yuji Masuda for performing the measurements of spleen and liver stiffness by ARFI imaging.

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Hirofumi Tomita, Yasushi Fuchimoto, Ken Hoshino, Akihiro Fujino, Mototoshi Kato, Takumi Fujimura, Hideo Ishihama, Nobuhiro Takahashi, Masahiro Shinoda, Yuko Kitagawa & Tatsuo Kuroda

  2. Division of Surgery, Department of Surgical Subspecialties, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan

    Yasushi Fuchimoto

  3. Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Kiyoshi Ohkuma, Yutaka Tanami & Seishi Nakatsuka

  4. Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Hirotoshi Ebinuma & Hidetsugu Saito

Authors
  1. Hirofumi Tomita
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  2. Yasushi Fuchimoto
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  3. Kiyoshi Ohkuma
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Correspondence to Yasushi Fuchimoto.

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Tomita, H., Fuchimoto, Y., Ohkuma, K. et al. Spleen stiffness measurements by acoustic radiation force impulse imaging after living donor liver transplantation in children: a potential quantitative index for venous complications. Pediatr Radiol 45, 658–666 (2015). https://doi.org/10.1007/s00247-014-3215-6

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  • DOI: https://doi.org/10.1007/s00247-014-3215-6

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