ABSTRACT
To clarify inconsistencies in the literature we performed a systematic review to identify the incidence, risk factors and outcome of early hepatic artery thrombosis (eHAT) after liver transplantation. We searched studies identified from databases (MEDLINE, EMBASE, Science Citation Index) and references of identified studies. Seventy-one studies out of 999 screened abstracts were eligible for this systematic review. The incidence of eHAT was 4.4% (843/21, 822); in children 8.3% and 2.9% in adults (p < 0.001). Doppler ultrasound screening (DUS) protocols varied from 'no routine' to 'three times a day.' The median time to detection was at day seven. The overall retransplantation rate was 53.1% and was higher in children (61.9%) than in adults (50%, p < 0.03). The overall mortality rate of patients with eHAT was 33.3% (range: 0-80%). Mortality in adults (34.3%) was higher than in children (25%, p < 0.03). The reported risk factors for eHAT were, cytomegalovirus mismatch (seropositive donor liver in seronegative recipient), retransplantation, arterial conduits, prolonged operation time, low recipient weight, variant arterial anatomy, and low volume transplantation centers. eHAT is associated with significant graft loss and mortality. Uniform definitions of eHAT and uniform treatment modalities are obligatory to confirm these results and to obtain a better understanding of this disastrous complication.
Subject(s)
Hepatic Artery/pathology , Liver Transplantation/adverse effects , Thrombosis/epidemiology , Adult , Age Factors , Child , Graft Rejection/epidemiology , Graft Rejection/surgery , Humans , Liver Transplantation/mortality , Postoperative Complications/epidemiology , Postoperative Complications/mortality , Postoperative Complications/surgery , Reoperation/mortality , Reoperation/statistics & numerical data , Risk Factors , Survival Analysis , Survivors , Thrombosis/diagnostic imaging , Thrombosis/mortality , Thrombosis/surgery , Treatment Failure , Treatment Outcome , UltrasonographyABSTRACT
The Dutch Government wants to curb the cost of Health Care. Running as high as 10% of the National Income, there is every reason for support. Imaging professionals, like radiologists, are vital for the discovery of disease in society. They need expensive equipment, not only to satisfy their professional pride but foremost to try to discover disease early and before having to put money into treatment of disease that is needlessly advanced and really beyond cure. Personal-PACS is not only cheap, it also makes X-ray departments much more efficient and gives radiologists a better image. The amazing thing, however, is that it proves to be the perfect tool to convince colleagues as well as decision makers.
Subject(s)
Hospital Information Systems , Radiology Information Systems , Image Processing, Computer-Assisted , Microcomputers , Netherlands , Radiology Department, Hospital/organization & administration , SoftwareABSTRACT
Biphasic gastric studies combining the advantages of both single- (positive) and double-contrast techniques performed under hypotony can now be accomplished as a routine procedure. In a series of 5,000 studies, the standardized method averaged only 15 minutes per patient.
Subject(s)
Digestive System/diagnostic imaging , Barium Sulfate/administration & dosage , Glucagon/administration & dosage , Humans , Methods , RadiographyABSTRACT
The case history of one patient is discussed to illustrate radiographic features, etiology and prognosis of gas bubbles in the gastric wall.
Subject(s)
Gases , Stomach Diseases/diagnostic imaging , Female , Household Products , Humans , Hypochlorous Acid , Middle Aged , Radiography , Stomach Diseases/chemically induced , Stomach Diseases/physiopathologyABSTRACT
Supine vertical beam films in double contrast studies of the stomach often show "barium spots" projecting on anterior wall polyps and folds. The supposition that these spots are caused by droplets of barium hanging from such protuberances is proved radiographically using horizontal beam techniques.
