Effect of respiration on the spectral Doppler wave of the right hepatic vein in right lobe living donor liver transplant recipients.
OBJECTIVE
The purpose of this study was to evaluate the effect of respiration on the spectral Doppler wave of the right hepatic vein (RHV) in right lobe living donor liver transplant (LDLT) recipients.


METHODS
A spectral Doppler wave of the RHV was obtained from 23 consecutive right lobe LDLT recipients who had no complications and from 26 healthy subjects during free breathing, breath holding at expiration, and breath holding at inspiration. To assess the RHV flow quantitatively, the venous periodicity index (VPI) was calculated as follows: VPI=(V(F)-V(R))/V(F), where V(F) was the measured peak forward velocity, and V(R) was the measured peak reversed velocity. The mean VPIs of the RHV obtained in the 3 respiratory states were compared by repeated measures analysis of variance. Spectral Doppler waves of the RHV were categorized as triphasic with or without reversed flow, biphasic, or monophasic and were compared among the 3 respiratory states.


RESULTS
In both right lobe LDLT recipients and healthy subjects, the mean VPIs of the RHV obtained during breath holding at inspiration were significantly lower than those during free breathing (P<.001) and breath holding at expiration (P<.001). The wave pattern during breath holding at inspiration was monophasic in 7 (30.4%) right lobe LDLT recipients and 3 (11.5%) healthy subjects, whereas the monophasic pattern was not seen during free breathing or breath holding at expiration in any of these subjects.


CONCLUSIONS
Breath holding at inspiration significantly reduces the periodicity of RHV flow and can make otherwise pulsatile RHV flow monophasic in right lobe LDLT recipients without postoperative complications as well as in healthy individuals.
Lee
Seung Soo
SS
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2 dong, Songpa-ku, Seoul 138-736, Korea.
Kim
Kyoung Won
KW
Park
Beom Jin
BJ
Shin
Yong Moon
YM
Kim
Pyo Nyun
PN
Lee
Moon-Gyu
MG
Lee
Sung Gyu
SG
D000328:Adult; D000368:Aged; D016477:Artifacts; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging*; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods*