Prospective evaluation of the role of quantitative Doppler ultrasound surveillance in liver transplantation.
Doppler ultrasound (DUS) is able to measure parameters of blood flow within vessels of transplanted organs, and vascular complications are associated with abnormal values. We analyzed the findings of 51 consecutive patients who underwent DUS on 2 occasions in the first postoperative week following liver transplantation for cirrhosis to determine the range of values in patients following liver transplantation. Three patients developed early vascular thromboses that were detected by the absence of a Doppler signal. In patients making an uneventful recovery, the arterial velocity tended to increase and the resistive index (RI) to decrease during the first postoperative week. All recipients were shown to have high-velocity segments within the hepatic artery, without an increase in flow resistance. Assessment of the portal vein revealed narrowing at the anastomosis, associated with a segmental doubling of flow velocity, and the mean portal venous flow decreased by approximately 20% in the first postoperative week. In conclusion, a wide range of abnormalities occurs in the vessels of liver transplant recipients, which were not associated with the development of vascular complications or affect patient management.
Stell
David
D
Multi-Organ Transplant Program, London Health Sciences Centre, London, Ontario, Canada. davidstell@doctors.org.uk
Downey
Donal
D
Marotta
Paul
P
Solano
Edward
E
Khakhar
Anand
A
Quan
Douglas
D
Ghent
Cam
C
McAlister
Vivian
V
Wall
William
W
D001783:Blood Flow Velocity; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000502:physiology*; D011184:Postoperative Period; D011446:Prospective Studies; D012039:Regional Blood Flow; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance