Objective. Evaluate the incidence of nephrogenic systemic fibrosis (NSF) in patients with liver disease in the peritransplant period.Materials and Methods. This IRB approved study retrospectively reviewed patients requiring transplantation for cirrhosis, hepatocellular carcinoma (HCC), or both from 2003 to 2013. Records were reviewed identifying those having gadolinium enhanced MRI within 1 year of posttransplantation to document degree of liver disease, renal disease, and evidence for NSF.Results. Gadolinium-enhanced MRI was performed on 312 of 837 patients, including 23 with severe renal failure (GFR < 30 mL/min/1.73 cm2) and 289 with GFR > 30. Two of 23 patients with renal failure developed NSF compared to zero NSF cases in 289 patients with GFR > 30 (0/289;P<0.003). High dose gadodiamide was used in the two NSF cases. There was no increased incidence of NSF with severe liver disease (1/71) compared to nonsevere liver disease (1/241;P=0.412).Conclusion. Renal disease is a risk factor for NSF, but in our small sample our evidence suggests liver disease is not an additional risk factor, especially if a low-risk gadolinium agent is used. Noting that not all patients received high-risk gadolinium, a larger study focusing on patients receiving high-risk gadolinium is needed to further evaluate NSF risk in liver disease in the peritransplant period.
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机译：目的。评估移植围手术期肝病患者肾源性系统性纤维化（NSF）的发生率。材料和方法。该IRB批准的研究回顾了2003年至2013年需要肝硬化，肝细胞癌（HCC）或两者同时需要移植的患者。对记录进行了鉴定，以鉴定在移植后1年内具有enhanced增强MRI的患者，以记录肝病，肾病和NSF的证据。对837例患者中的312例进行了d增强MRI，包括23例严重肾衰竭（GFR <30 mL / min / 1.73 cm2）和289例肾病GFR>30。23例肾衰竭的患者中有2例发展为NSF，而NSF病例为零在289名GFR> 30（0/289; P <0.003）的患者中。在两个NSF病例中使用了高剂量的gadodiamide。与非严重肝病（1/241; P = 0.412）相比，重症肝病（1/71）的NSF发生率没有增加。肾脏疾病是NSF的危险因素，但在我们的小样本中，我们的证据表明肝脏疾病不是其他危险因素，尤其是如果使用低风险的g试剂。注意到并非所有患者都接受了高风险g，需要开展一项针对高风险g患者的更大研究，以进一步评估围手术期肝病中NSF的风险。
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