TY - JOUR AU - Bhogal, Sumail AU - Minn, Matthew AU - Krishnan, Pranay AU - Jha, Reena C. PY - 2019 DA - 2019/11/18 TI - Incidence, Location, and Natural History of Perihepatic Fluid Collections after Orthotopic Liver Transplantation JO - OBM Transplantation SP - 092 VL - 03 IS - 04 AB - Objective: The purpose of this study was to evaluate the common locations of perihepatic fluid collections after liver transplantation, assess their complexity, and understand their natural history and clinical significance. Materials and Methods: A retrospective analysis of 189 postoperative orthotopic liver transplant patients was performed using serial CT or MRI to characterize perihepatic fluid collections. Location, size, complexity of the collections, and clinical course were evaluated. Results: 76 patients (40%) presented with perihepatic fluid collections with a total of 116 collections. 45 pts (59%), had a one collection, 23 pts (30%) had two, 7 pts (9%) had three and one patient (1%) had four. Collections were seen in predictable locations, with 38 (33%) in segment 5/6, 37 (32%) in the ligamentum venosum/pericaval region, 12 (10%) in the porta hepatis, 11 (9%) the pericapsular/subdiagphramatic location, 10 (9%) along the fissure for ligamentum teres, and the remaining 8 (7%) collections in ‘other’ less frequent perihepatic locations. The vast majority, 100/116 (86%) of all collections were simple and 95/105 (90%) of the collections resolved, decreased or stable on follow up. Collections located in pericapsular /subdiaphragmatic region were significantly more likely to be complex. 16/116 (14%) of the collections were complex, and 4 of these required intervention. Conclusions: Perihepatic fluid collections are seen in 40 % of patients after liver transplant. Fluid collections are often in predictable locations, most commonly seen in segment 5/6, the ligamentum venosum/ pericaval region, the porta hepatis, and the fissure for ligamentum teres. Collections in these locations tend to be simple by imaging criteria and rarely require follow up. Radiologists interpreting post liver transplant patients should be familiar with the common locations of these collections, and when asymptomatic, recognize these as incidental. Further evaluation may be warranted if collections are symptomatic, enlarging, have complex imaging features, or located in an atypical location. SN - 2577-5820 UR - https://doi.org/10.21926/obm.transplant.1904092 DO - 10.21926/obm.transplant.1904092 ID - Bhogal2019 ER -