Sonographic evaluation of vessel grafts in living donor liver transplantation recipients of the right lobe.
OBJECTIVE
To evaluate the vessel grafts (VG) used to reconstruct the middle hepatic vein (MHV) tributaries with ultrasonography.


METHODS
Twenty-four patients undergone living donor liver transplantation were enrolled in our study. MHV tributaries larger than 5 mm in diameter were reconstructed with interposition VG. Blood flow of the graft and interposition VG was checked by Doppler ultrasonography daily in the first 2 postoperative weeks and monthly followed up after discharge. The sensitivity of VG detected by ultrasonography was assessed using surgical records as references. Student's t test was used to compare the velocity of VG and occluded VG in chronic patents (> 3 mo).


RESULTS
Thirty-one VG were used to reconstruct the MHV tributaries. Ultrasonography identified 96.7% (30/31) of large MHV tributaries and 90.3% (28/31) of VG. The diameter of VG was 5.6 +/- 0.8 mm and the velocity of VG was 19.7 +/- 8.1 cm/s. Two VG (2/31, 6.5%) were occluded on the first postoperative day in one patient who suffered from persistent ascites and had a prolonged recovery of liver function. Twenty-six VG (26/31, 83.9%) were patent 2 wk after operation. Six (6/31, 19.4%) VG were patent over 3 mo after operation. Intrahepatic venous collaterals were detected in 29.2% (7/24) patients. The velocity of VG and occluded VG was 30.1 +/- 5.6 cm/s, 16.5 +/- 5.8 cm/s, respectively, in chronic patents. The difference between two groups was statistically significant (P < 0.001).


CONCLUSIONS
Our results indicate that most VG are patent in the first postoperative week while only a small portion with a higher velocity remains patent after 3 mo. Intrahepatic venous collaterals can be observed in some patients after occlusion of VG.
Lu
Qiang
Q
Department of Sonography, West China Hospital, Sichuan University, Chengdu 610041, China.
Wu
Hong
H
Fan
Yu-Ting
YT
Luo
Yan
Y
Zhang
Zhong-Wei
ZW
D000328:Adult; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation / Q000000981:diagnostic imaging*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D014654:Vascular Patency; D055815:Young Adult