Liver graft calcifications in a case of acute rejection

Abstract

Imaging exams are widely used in the evaluation of complications after liver transplantation, however, reports in the literature of graft calcifications are rare and nonspecific, and may refer more frequently to injury-reperfusion damage, ischemia or even rejection. We report a case of a male patient, forty-eight years old, diabetic and hypertensive, hospitalized for liver transplantation due to cryptogenic cirrhosis and schistosomiasis. About twenty days after the transplant, he presented changes in clinical and biochemical parameters with elevation of canalicular enzymes and hyperbilirubinemia, notably direct bilirubin, with imaging exams showing pericapsular dystrophic hepatic calcifications, as well as hepatic artery stenosis, with angioplasty performed without placement of stent. Biopsy of the liver graft showed acute cell rejection. Further studies are needed with a greater description and characterization of post-transplant liver calcifications, as well as an understanding of the mechanisms that provide these calcifications, insofar as the early detection of post-transplant complications will help to reduce morbidity rates and allow graft recovery in selected cases.