Significance of and contributing factors for a high resistive index on Doppler sonography of the hepatic artery immediately after surgery: prognostic implications for liver transplant recipients.
OBJECTIVE
The goal of our study was to investigate the contributing factors, clinical repercussions, and implications for prognosis of high-resistance flow at the hepatic artery detected on Doppler sonography during the period immediately after orthotopic liver transplantation.


METHODS
We retrospectively studied the transplanted livers of 90 patients who had been examined on Doppler sonography within the first 3 days after grafting. Seventeen variables from organ donors, transplant recipients, graft characteristics, and surgical procedures were investigated. Early clinical evolution was also analyzed. Follow-up was performed for 5 years.


RESULTS
Forty-one (45.6%) of the 90 patients showed a high resistive index at the hepatic artery during the first 72 hr after transplantation. Two factors showed a statistically significant effect on the occurrence of a high resistive index at the hepatic artery immediately after transplantation: an older liver donor (p = 0.008) and extended preservation time (p = 0.005). No relation with early graft function was detected. The incidence of bile duct complications, retransplantation, or death was not higher at follow-up in patients with high-resistance flow than in those with normal flow.


CONCLUSIONS
High-resistance flow at the hepatic artery detected on Doppler sonography during the period immediately after transplantation is a frequent finding and is related to older donor age and prolonged period of ischemia. This finding has neither significant clinical repercussions nor prognosis implications for early and long-term follow-up.
García-Criado
Angeles
A
Imaging Diagnosis Center, Clinic Hospital, Villarroel 170, 08036 Barcelona, Spain. magarcia@clinic.ub.es
Gilabert
Rosa
R
Salmerón
J Manuel
JM
Nicolau
Carlos
C
Vilana
Ramón
R
Bianchi
Luis
L
Buñesch
Laura
L
García-Valdecasas
J Carlos
JC
Rimola
Antoni
A
Brú
Concepción
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D017093:Liver Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance / Q000502:physiology*