Liver transplant rejection: value of hepatic vein Doppler waveform analysis.
BACKGROUND
To determine whether abnormal hepatic vein Doppler tracings can be used to predict liver transplantation rejection.


METHODS
A total of 158 hepatic vein Doppler tracings were obtained on 93 postliver transplant patients (63 patients without rejection and 30 patients with biopsy-proven rejection). Hepatic vein Doppler tracings were scored according to an established grading system (0 = normal triphasic waveform, 1 = dampened waveform, with loss of flow reversal, 2 = completely flat waveform). The hepatic vein Doppler tracings were then correlated with biopsy findings.


RESULTS
In the group of 63 patients without rejection, 124 Doppler examinations were performed and graded as follows: 0 = 87 (70%), 1 = 31 (25%), and 2 = 6 (5%). In the group of 30 patients with biopsy-proven rejection, 34 Doppler examinations were performed and graded as follows: 0 = 16 (47%), 1 = 14 (41%), and 2 = 4 (12%). The sensitivity of abnormal hepatic vein Doppler tracings for detection of rejection was 53% and the specificity was 70%. The positive predictive value of an abnormal hepatic vein Doppler tracing was 33% and the negative predictive value of a normal Doppler tracing was 84%.


CONCLUSIONS
Abnormal hepatic vein Doppler tracings are observed in patients with and without liver transplant rejection. Abnormal tracings cannot be used to predict liver transplant rejection.
Zalasin
S
S
Department of Radiology, Mount Sinai Medical Center, New York, NY 10029-6574, USA.
Shapiro
R S
RS
Glajchen
N
N
Stancato-Pasik
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D001783:Blood Flow Velocity; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging; D016031:Liver Transplantation / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler