Multidetector computed tomography angiography in detection of active bleeding in renal and liver transplant recipients.

Objectives: The aim of this study was to evaluate the effectivity of multidetector computed tomography angiography (MDCT-A) to detect active bleeding in transplant patients.

Materials And Methods: Between 1999 and 2006, 532 patients underwent renal or liver transplantation. MDCT-A was performed on recipients who displayed decreased hemoglobin levels or who had a hematoma during abdominal ultrasound imaging. The MDCT-A used a 16-detector CT device (Siemens, Sensation) with slices 0.75 mm thick after injection of nonionic contrast media (4 mL per second). A multiple intensity projection (MIP) technique was used to maintain angiographic images in the axial and coronal planes.

Results: MDCT-A detected active bleeding among 23 posttransplant patients: 10 of arterial origin and 13 venous, as proven either by angiography or during operation. Among 8 of the 11 patients who underwent angiographic imaging the arterial origin was embolized. For three patients the angiographic evaluation was not helpful to find the bleeding point. A cohort of 5 of 12 patients did not undergo angiographic evaluation and were followed by clinical and ultrasonographic findings. Seven patients underwent re-operating.

Discussion: Management of the patients who were suspected to have active bleeding after renal or liver transplantation was benefitted by MDCT-A as an accurate and feasible screening modality.