Abdominal and GI imaging: biliary ischaemia after liver transplant: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Abdominal and GI imaging: biliary ischaemia after liver transplant

Sample item

A liver transplant recipient on day 4 has fever and rising bilirubin. Doppler shows no flow in the hepatic artery. Why do the bile ducts become necrotic and leak in this setting?

AThe donor bile ducts depend solely on arterial blood supplyBThe portal vein drains bile into the graftCCold storage leaves the ducts without mucosaDHepatic venous outflow is blocked

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. The donor bile ducts depend solely on arterial blood supply

Hepatic artery thrombosis is the most serious early vascular complication of liver transplantation. The biliary tree receives blood only from the hepatic artery through the peribiliary plexus, so thrombosis causes ductal ischaemia, strictures, leaks and graft loss. Portal and venous flows do not supply bile ducts.

Option by option

A. The donor bile ducts depend solely on arterial blood supply (correct)
Correct. The bile ducts rely on the hepatic artery alone.
B. The portal vein drains bile into the graft
The portal vein carries blood to the liver and does not drain bile.
C. Cold storage leaves the ducts without mucosa
Cold preservation does not remove mucosa; this is an acute vascular complication.
D. Hepatic venous outflow is blocked
Venous outflow obstruction causes congestion, not selective biliary necrosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, The donor bile ducts depend solely on arterial blood supply. Hepatic artery thrombosis is the most serious early vascular complication of liver transplantation.

Why is "The portal vein drains bile into the graft" not the answer?

The portal vein carries blood to the liver and does not drain bile.

Why is "Cold storage leaves the ducts without mucosa" not the answer?

Cold preservation does not remove mucosa; this is an acute vascular complication.

Why is "Hepatic venous outflow is blocked" not the answer?

Venous outflow obstruction causes congestion, not selective biliary necrosis.

What concept does this question test?

It tests Abdominal and GI imaging: biliary ischaemia after liver transplant in Radiology. The biliary tree receives blood only from the hepatic artery through the peribiliary plexus, so thrombosis causes ductal ischaemia, strictures, leaks and graft loss. Portal and venous flows do not supply bile ducts.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdominal and GI imaging: biliary ischaemia after liver transplant?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.