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Transplantation ; 103(6): e159-e163, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30801544

RESUMEN

BACKGROUND: Intravenous contrast-enhanced imaging is invaluable in diagnosing pathology following liver transplantation. Given the potential risk of contrast nephropathy associated with iodinated computed tomography contrast, alternate contrast modalities need to be examined, especially in the setting of renal insufficiency. The purpose of this study was to examine the renal safety of MRI with gadolinium following liver transplantation. METHODS: The study involved a retrospective analysis of 549 cases of abdominal MRI with low-dose gadobenate dimeglumine in liver transplant recipients at a single center. For each case, serum creatinine values before and after the MRI were compared. In addition, cases were analyzed for the development of nephrogenic systemic fibrosis. RESULTS: Pre-MRI creatinine values ranged from 0.32 to 6.57 mg/dL (median, 1.28 g/dL), with 191 cases having values ≥1.5 mg/dL (median, 1.86 g/dL). A comparison of the pre- and post-MRI creatinine values showed no significant difference, including those patients with pre-MRI values ≥1.5 mg/dL (mean change of -0.04 [95% confidence interval, -0.07 to -0.01; P = 0.004]). No cases of nephrogenic systemic fibrosis were noted. CONCLUSIONS: Our findings suggest that, irrespective of baseline renal function, MRI with gadobenate dimeglumine is a nonnephrotoxic imaging modality in liver transplant recipients. Importantly, this intravenous contrast-enhanced imaging modality can be considered in those posttransplant patients who have a contraindication to computed tomography contrast due to renal insufficiency.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Medios de Contraste/efectos adversos , Trasplante de Hígado/efectos adversos , Imagen por Resonancia Magnética/efectos adversos , Meglumina/análogos & derivados , Dermopatía Fibrosante Nefrogénica/inducido químicamente , Compuestos Organometálicos/efectos adversos , Complicaciones Posoperatorias/diagnóstico por imagen , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/epidemiología , Administración Intravenosa , Adulto , Anciano , Biomarcadores/sangre , Medios de Contraste/administración & dosificación , Creatinina/sangre , Femenino , Georgia/epidemiología , Humanos , Incidencia , Masculino , Meglumina/administración & dosificación , Meglumina/efectos adversos , Persona de Mediana Edad , Dermopatía Fibrosante Nefrogénica/diagnóstico , Dermopatía Fibrosante Nefrogénica/epidemiología , Compuestos Organometálicos/administración & dosificación , Complicaciones Posoperatorias/epidemiología , Insuficiencia Renal/diagnóstico , Insuficiencia Renal/epidemiología , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo
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