Renal Safety of Intravenous Gadolinium-enhanced MRI in Patients Following Liver Transplantation

Transplantation. 2019 Jun;103(6):e159-e163. doi: 10.1097/TP.0000000000002678.


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.

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / epidemiology
  • Administration, Intravenous
  • Adult
  • Aged
  • Biomarkers / blood
  • Contrast Media / administration & dosage
  • Contrast Media / adverse effects*
  • Creatinine / blood
  • Female
  • Georgia / epidemiology
  • Humans
  • Incidence
  • Liver Transplantation / adverse effects*
  • Magnetic Resonance Imaging / adverse effects*
  • Male
  • Meglumine / administration & dosage
  • Meglumine / adverse effects
  • Meglumine / analogs & derivatives*
  • Middle Aged
  • Nephrogenic Fibrosing Dermopathy / chemically induced*
  • Nephrogenic Fibrosing Dermopathy / diagnosis
  • Nephrogenic Fibrosing Dermopathy / epidemiology
  • Organometallic Compounds / administration & dosage
  • Organometallic Compounds / adverse effects*
  • Postoperative Complications / diagnostic imaging*
  • Postoperative Complications / epidemiology
  • Renal Insufficiency / diagnosis
  • Renal Insufficiency / epidemiology
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors


  • Biomarkers
  • Contrast Media
  • Organometallic Compounds
  • gadobenic acid
  • Meglumine
  • Creatinine