European Radiology

, Volume 28, Issue 6, pp 2572–2581 | Cite as

Computed tomography findings in ABO-incompatible living donor liver transplantation recipients with biliary strictures

  • Sang Hyun Choi
  • Kyoung Won KimEmail author
  • So Yeon Kim
  • Jin Sil Kim
  • Jae Hyun Kwon
  • Gi-Won Song
  • Sung-Gyu Lee



To evaluate CT findings of biliary strictures in ABO-incompatible living donor liver transplantation (LDLT) recipients, with emphasis on associated 1-month post-transplantation CT findings, and evaluate clinical outcomes.


Of 351 ABO-incompatible recipients, we retrospectively evaluated CT scans in 65 recipients with biliary stricture. The biliary strictures on CT scans were classified as type A (perihilar) and type B (diffuse). Precedent CT abnormality patterns and the presence of a periportal halo sign at 1-month post-transplantation were evaluated. For each patient, clinical outcomes were evaluated.


Of 65 ABO-incompatible recipients with biliary strictures, 36.9% had type B strictures. Compared with biliary strictures at diagnosis, similar CT abnormality patterns were observed for 84.4% in type A and 86.4% in type B strictures at 1-month post-transplantation. Complex periportal halo signs on the 1-month post-transplantation CT were more frequently noted for type B than type A strictures (86.4% vs. 3.1%, P < 0.001). Progressive clinical outcomes were more frequently observed for type B than type A strictures (79.2% vs. 26.8%, P < 0.001), with a significantly shorter graft survival time (46.4 months vs. 90.8 months, P < 0.001).


CT abnormality patterns and complex periportal halo signs on 1-month post-transplantation CT may be clinically useful for managing biliary strictures in ABO-incompatible LDLT recipients.

Key Points

• Of ABO-incompatible LDLT recipients, type B biliary stricture incidence was 6.8%.

• Of type B strictures, 86.4% exhibited similar CT abnormality patterns at 1-month post-transplantation.

• Complex periportal halo at 1 month was significantly associated with type B strictures.

• Progressive clinical outcomes were more frequently observed in type B strictures.


Liver transplantation Bile ducts Computed tomography Blood group incompatibility Outcome 



living donor liver transplantation


computed tomography


hepatobiliary scintigraphy


intrahepatic duct


model for end-stage liver disease


red blood cell


bile duct opening


bile duct


bile duct anastomosis


duct to duct





The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Kyoung Won Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• retrospective

• observational

• performed at one institution

Supplementary material

330_2017_5226_MOESM1_ESM.docx (18 kb)
ESM 1 (DOCX 18 kb)


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  1. 1.Department of Radiology and the Research Institute of RadiologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulKorea
  2. 2.Division of Liver Transplantation and Hepatobiliary Surgery, and Department of SurgeryUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulKorea

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