title: Hepatic arterial waveforms on early posttransplant Doppler ultrasound.
abstract: OBJECTIVE
  To determine the significance of spectral Doppler hepatic artery waveforms obtained in the first 10 days after primary liver transplantation and to determine the best early predictor of hepatic arterial thrombosis (HAT).
  
  
  METHODS
  A total of 645 patients were retrospectively followed up to 1 year after liver transplantation. Doppler waveforms of the hepatic arteries were categorized as normal, abnormally elevated, not visualized, or with resistive index (RI) <0.5 on all examinations performed within the first 10 days. Waveforms were then correlated with patient outcomes within 1 year.
  
  
  RESULTS
  Of the 645 patients, 83 (12.8%) had nonvisualization of at least one hepatic artery on Doppler evaluation and 56 (8.7%) developed HAT or stenosis within the first year after transplantation. Odds ratios (ORs) demonstrate that a single nonvisualized hepatic artery (OR, 9.66; 95% confidence interval [CI], 4.51-20.70) has a much higher incidence of HAT in the first 10 days after transplantation compared to low RI (OR, 1.93; 95% CI, 0.77-4.79)] or high RI (OR, 1.06; 95% CI, 0.44-2.55]. The loss or reversal of diastolic flow on Doppler ultrasound performed in the first 10 days after transplantation does not seem to correlate with active or impending HAT.
  
  
  CONCLUSIONS
  Absence of hepatic arterial flow Doppler signal in the first 10 days after liver transplantation is associated with higher incidence of thrombosis than previously demonstrated, whereas persistently high diastolic flow early on seems to be more significant and leads to further hepatic arterial complications than decreased diastolic flow.
authors.affiliation: Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA. Wade_Hedegard@URMC.rochester.edu
authors.forename: Wade C
authors.initials: WC
authors.lastname: Hedegard
authors.forename: Shweta
authors.initials: S
authors.lastname: Bhatt
authors.forename: Wael
authors.initials: W
authors.lastname: Saad
authors.forename: Deborah
authors.initials: D
authors.lastname: Rubens
authors.forename: Vikram
authors.initials: V
authors.lastname: Dogra
mesh_terms: D001783:Blood Flow Velocity; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology; D018608:Ultrasonography, Doppler