Diagnostic value of early postoperative color doppler ultrasonography to predict vascular complications following liver transplantation
Researcher Bulletin of Medical Sciences,
Vol. 24 No. 1 (2019),
Introduction: Blood flow and hemodynamic of the transplanted liver has an important predictive role in the survival of the patients. We aimed to determine the diagnostic value of early post-operative color doppler ultrasonography (CDU) for detecting vascular complications following liver transplantation at our center.
Materials and Methods: In this prospective study, consecutive patients who underwent deceased donor liver transplantation between March 2016 and March 2017 were enrolled. Color Doppler ultrasonography was performed within the first week following surgery. The follow-up CDU was performed after 1 year from the liver transplantation. Using the ﬁndings of follow up CDU as the reference standard, we calculated values of the capability of the initial CDU in the diagnosis of the hepatic artery, portal vein and intrahepatic veins' stenosis, including the level of agreement, sensitivity, speciﬁcity, positive predictive value, negative predictive value, and diagnostic accuracy.
Results: The data of 50 patients were analyzed in this study (mean age=38.9±13.2 years, 26 [52%] men). In the initial ultrasonography, 16 cases had hepatic artery stenosis, 4 cases had portal vein stenosis and 4 patients had IVC stenosis. The diagnostic value of the early postoperative CDU for hepatic artery stenosis, portal vein stenosis, and other vascular stenosis were 71.9, 96.0, and 62.0, respectively.
Conclusion: Early post-operative CDU is a safe and feasible method that can detect the development of hepatic artery or portal vein stenosis in liver transplant recipients with a low to moderate positive predictive value and a high negative predictive value.
- Liver transplantation; Color doppler ultrasonography; Portal vein stenosis; Hepatic artery stenosis; Diagnosis
How to Cite
2. Mourad MM, Liossis C, Gunson BK, et al. Etiology and management of hepatic artery thrombosis after adult liver transplantation. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2014;20(6):713-723.
3. Zanetto A, Rodriguez-Kastro KI, Germani G, et al. Mortality in liver transplant recipients with portal vein thrombosis - an updated meta-analysis. Transplant international : official journal of the European Society for Organ Transplantation. 2018;31(12):1318-1329.
4. Rubenthaler J, Paprottka KJ, Hameister E, et al. Vascular complications in liver transplantation: Beneficial role of contrast-enhanced ultrasound (CEUS) in the postoperative phase. Clinical hemorheology and microcirculation. 2016;64(3):475-482.
5. Chung Y, Choi H, Na G, You Y, Park I. Postoperative Doppler Ultrasonography in Liver Transplantation. Paper presented at: Transplantation proceedings2018.
6. Sanyal R, Zarzour JG, Ganeshan DM, Bhargava P, Lall CG, Little MD. Postoperative doppler evaluation of liver transplants. The Indian journal of radiology & imaging. 2014;24(4):360-366.
7. Stell D, Downey D, Marotta P, et al. Prospective evaluation of the role of quantitative Doppler ultrasound surveillance in liver transplantation. Liver transplantation: official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2004;10(9):1183-1188.
8. Bolognesi M, Sacerdoti D, Mescoli C, et al. Acute liver rejection: accuracy and predictive values of doppler US measurements--initial experience. Radiology. 2005;235(2):651-658.
9. Crossin JD, Muradali D, Wilson SR. US of liver transplants: normal and abnormal. Radiographics : a review publication of the Radiological Society of North America, Inc. 2003;23(5):1093-1114.
10. Garcia-Criado A, Gilabert R, Nicolau C, et al. Early detection of hepatic artery thrombosis after liver transplantation by Doppler ultrasonography: prognostic implications. Journal of ultrasound in medicine. 2001;20(1):51-58.
11. Rossi S, Rosa L, Ravetta V, et al. Contrast-enhanced versus conventional and color Doppler sonography for the detection of thrombosis of the portal and hepatic venous systems. AJR American journal of roentgenology. 2006;186(3):763-773.
12. Ma L, Lu Q, Luo Y. Vascular complications after adult living donor liver transplantation: Evaluation with ultrasonography. World journal of gastroenterology. 2016;22(4):1617-1626.
13. Sidhu P, Ellis S, Karani J, Ryan S. Hepatic artery stenosis following liver transplantation: significance of the tardus parvus waveform and the role of microbubble contrast media in the detection of a focal stenosis. Clinical radiology. 2002;57(9):789-799.
14. Vit A, De Candia A, Como G, Del Frate C, Marzio A, Bazzocchi M. Doppler evaluation of arterial complications of adult orthotopic liver transplantation. Journal of clinical ultrasound. 2003;31(7):339-345.
15. Mullan CP, Siewert B, Kane RA, Sheiman RG. Can Doppler sonography discern between hemodynamically significant and insignificant portal vein stenosis after adult liver transplantation? AJR American journal of roentgenology. 2010;195(6):1438-1443.
16. Abdelaziz O, Attia H. Doppler ultrasonography in living donor liver transplantation recipients: Intra-and post-operative vascular complications. World journal of gastroenterology. 2016;22(27):6145.
17. Khalaf H. Vascular complications after deceased and living donor liver transplantation: a single-center experience. Transplantation proceedings. 2010;42(3):865-870.
18. Lafortune M, Patriquin H. The hepatic artery studies using Doppler sonography. Ultrasound Quarterly. 1999;15(1):9-26.
19. Park YS, Won Kim K, Lee SJ, et al. Hepatic arterial stenosis assessed with doppler US after liver transplantation: frequent false-positive diagnoses with tardus parvus waveform and value of adding optimal peak systolic velocity cutoff. Radiology. 2011;260(3):884-891.
20. Huang TL, Cheng YF, Chen TY, et al. Doppler ultrasound evaluation of postoperative portal vein stenosis in adult living donor liver transplantation. Transplantation proceedings. 2010;42(3):879-881.
21. Jia Y-P, Lu Q, Gong S, et al. Postoperative complications in patients with portal vein thrombosis after liver transplantation: evaluation with Doppler ultrasonography. World Journal of Gastroenterology: WJG. 2007;13(34):4636.
22. Kim SY, Kim KW, Choi SH, et al. Feasibility of UltraFast Doppler in Post-operative Evaluation of Hepatic Artery in Recipients following Liver Transplantation. Ultrasound in medicine & biology. 2017;43(11):2611-2618.
23. Sanyal R, Lall CG, Lamba R, et al. Orthotopic liver transplantation: reversible Doppler US findings in the immediate postoperative period. Radiographics : a review publication of the Radiological Society of North America, Inc. 2011;32(1):199-211.
24. García-Criado Á, Gilabert R, Berzigotti A, Brú C. Doppler ultrasound findings in the hepatic artery shortly after liver transplantation. American Journal of Roentgenology. 2009;193(1):128-135.
- Abstract Viewed: 0 times
- e22 Downloaded: 0 times