Prediction of early hepatic artery thrombosis by intraoperative color Doppler ultrasound in pediatric segmental liver transplantation.
Early hepatic artery thrombosis (eHAT) after transplantation is associated with a high incidence of graft failure and mortality in pediatric segmental liver transplantation (LT). The evaluation of intraoperative color Doppler ultrasound (CD-US) parameters and their sensitivity and specificity for the prediction of eHAT were important. Pediatric segmental LTs were performed in 49 consecutive patients from October 2006 to December 2010 in our hospital. A total of seven patients (14.3%) experienced eHAT (within one month) after LT. The intraoperative hepatic artery (HA) diameter (p = 0.026), hepatic arterial peak systolic velocity (HAPSV) (p = 0.006), and hepatic artery resistance index (HARI) (p = 0.000) had significant difference between eHAT group and non-eHAT group. Taking a HA diameter <2 mm, a HAPSV of <40 cm/s and a HARI of <0.6 as threshold to predict eHAT, the sensitivity and specificity were 85.7%, 85.7%, 85.7%, and 61.9%, 76.2%, 88.1%, respectively. A HARI of <0.6 was shown to be the most sensitive and specific single parameter for predicting eHAT.
Department of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Li H
LH
Gu
Hua
H
Fang
Feng H
FH
Li
Ping
P
Li
Cai X
CX
Zhu
Jian J
JJ
Zhu
Shi J
SJ
Zhang
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging / Q000401:mortality*; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012372:ROC Curve; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D018608:Ultrasonography, Doppler