Nephrogenic Systemic Fibrosis (NSF) & Liver Transplant Procedures

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NSF Risk from Gadolinium High for Liver Transplant Patients

NSF Linked to Gadolinium Contrast Dyes

Because it is rare, not much is known about NSF, but what studies have been done have consistently shown an association between NSF and gadolinium contrast dyes used in MRI procedures.

In 2006, Dutch researchers where the first to link NSF with the use of gadolinium contrast dyes. In a small study, they discovered that 5 of 9 patients diagnosed with NSF had received a MRI involving use of Omniscan Contrast Dye, a gadolinium-based contrast agent manufactured by General Electric. According to the CDC, the study indicated that exposure to gadolinium-containing contrast agents during MRI studies was linked with the development of NSF.  The CDC cautioned that clinicians should be aware of the potential for NSF, and when possible, should avoid use of gadolinium-containing contrast agents in patients with advanced kidney disease.

Nephrogenic Systemic Fibrosis & Liver Transplant

A 2009 study published in the Archives of Dermatology found that dialysis patients and liver transplant patients exposed to gadolinium contrast dyes face a higher risk of developing NSF.

The study involved 94,917 patients exposed to gadolinium agents at the Mayo Clinic between January 1, 1999 and December 31, 2006. Of that group, 3,779 patients were on hemodialysis, 1,694 patients had undergone a kidney transplant, and 717 patients had liver transplants. A total of 61 patients had a clinical diagnosis of NSF.

The study concluded that NSF develops in people with pre-existing kidney disease who are exposed to the gadolinium agents. In September 2007, the U.S. Food & Drug Administration (FDA) asked the manufacturers of all gadolinium contrast dyes to add a black box warning to the product labels about its association with NSF. The FDA also warned that patients with kidney disease should avoid gadolinium contrast agents, and that the lowest possible dosage should be administered to such patients if use of the dyes cannot be avoided.

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