Risk of nephrogenic systemic fibrosis in liver transplantation patients

Daniel S. Chow, Simin Bahrami, Steven S. Raman, Sepehr Rotchel, James W. Sayre, Ronald W. Busuttil, David S. Lu

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

OBJECTIVE. The purpose of our study was to evaluate the exposure of our institution's liver transplantation population to gadolinium-based contrast agents and assess the rate of nephrogenic systemic fibrosis (NSF) within this unique group. MATERIALS AND METHODS. Institutional review board approval was obtained for a retrospective review of medical records of patients who had undergone liver transplantation at our institution between 1997 and 2008. Informed consent was not required. Demographic information, history of gadolinium-based contrast agent exposure, stage of chronic kidney disease (CKD), and evidence of NSF were recorded. RESULTS. A total of 2142 patients who had undergone liver transplantation at our institution between 1997 and 2008 were identified. Of this total, 33% (709/2142) had documented gadolinium-based contrast agent exposure peritransplantation. Patients in CKD1 and 2, CKD3, CKD4, and CKD5 comprised 50% (352/709), 28% (200/709), 8% (60/709), and 14% (97/709), respectively. Of patients in CKD5, 76% (74/97) required dialysis. Thorough review of all patients' medical records identified one biopsy-confirmed case of NSF in the 709 patients. This patient was also in CKD5 and required dialysis. CONCLUSION. Within our institution, only 0.1% (1/709) of all liver transplantation patients exposed to gadolinium-based contrast agents or 1.4% (1/74) of CKD5 patients requiring dialysis had biopsy proof of NSF. This incidence is consistent with the rate of NSF in all patients exposed to gadolinium-based contrast agents regardless of liver transplantation reported in the literature. Therefore, liver transplantation may not be an independent risk factor in development of NSF in patients exposed to gadolinium-based contrast agents.

Original languageEnglish (US)
Pages (from-to)658-662
Number of pages5
JournalAmerican Journal of Roentgenology
Volume197
Issue number3
DOIs
StatePublished - Sep 2011

Keywords

  • Contrast agents
  • Gadolinium
  • Liver transplantation
  • MRI
  • Nephrogenic systemic fibrosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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