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Abstract #0939

Gadolinium Exposure Before or After Liver Transplantation: No Excess Risk of Nephrogenic Systemic Fibrosis (NSF)?

Elise Eva Saddleton1, Anne Laumann2, Dennis P. West2, Steven M. Belknap3, Brenda Schmitz1, Beatrice J. Edwards3, Nicole Papariello2, Michael I. Abecassis4, Frank H. Miller1

1Radiology, Northwestern University, Chicago, IL, United States; 2Dermatology, Northwestern University, Chicago, IL, United States; 3Medicine, Northwestern University, Chicago, IL, United States; 4Transplant Surgery, Northwestern University, Chicago, IL, United States


The FDAs 2007 warning describing the risk of nephrogenic systemic fibrosis (NSF) with gadolinium administration in patients with acute renal insufficiency of any severity due to hepatorenal syndrome or in the perioperative liver transplantation period poses a significant problem for practitioners who routinely use magnetic resonance imaging (MRI) to evaluate liver transplant patients. The warning appears to have been based on a few patients who received gadodiamide. We evaluated the use of gadolinium-based contrast agents (GBCAs) and the presence of NSF in a large liver transplant center. We hypothesized no increased risk of NSF in the perioperative liver transplant period beyond that associated with severe renal disease.