title: Diagnosis and Management of Hepatic Artery Complications After Liver Transplantation.
abstract: BACKGROUND
  We assessed the usefulness of color Doppler imaging in diagnosis and monitoring hepatic artery complications after liver transplantation.
  
  
  METHODS
  Subjects were 421 liver transplant recipients who underwent serial ultrasound (US) color Doppler evaluations of the hepatic arteries after surgery.
  
  
  RESULTS
  We saw 4 hepatic arterial complications after liver transplantation (13 thrombosis, 29 stenosis, 2 kinking, 2 pseudo-aneurysm, and 2 pseudo-aneurysm rupture). All subjects underwent US color Doppler examination periodically after surgery. In 6 cases of early thrombosis, hepatic arterial obstruction was diagnosed with absence of Doppler signals; in the other 7 cases (late hepatic artery thrombosis), thrombosis was suspected for the presence of intra-parenchymal "tardus-parvus" waveforms. In all of the cases, computed tomography angiography showed obstruction of the main arterial trunk and the development of compensatory collateral circles (late hepatic artery thrombosis). In 10 of the 29 cases of stenosis, Doppler ultrasonography examination revealed stenotic tract and intra-hepatic tardus-parvus waveforms; in 17 stenosis cases, the site of stenosis could not be identified, but intra-parenchymal tardus-parvus waveforms were recorded. In 2 patients, hepatic artery stenosis occurred with ischemic complications.
  
  
  CONCLUSIONS
  The use of US color Doppler examination allows the early diagnosis of hepatic arterial complications after liver transplantation. Tardus-parvus waveforms indicated severe impairment of hepatic arterial perfusion from either thrombosis or severe stenosis. The presence of these indirect signs enhanced the accuracy of color Doppler diagnosis, and detection should prompt therapy.
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Frongillo
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy. Electronic address: mcarmenlirosi@yahoo.it.
authors.forename: M C
authors.initials: MC
authors.lastname: Lirosi
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Nure
authors.affiliation: Department of Bio-Sciences and Radiological Imaging, Catholic University of the Sacred Heart, Rome, Italy, and Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Inchingolo
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bianco
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Silvestrini
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: A W
authors.initials: AW
authors.lastname: Avolio
authors.affiliation: Department of Bio-Sciences and Radiological Imaging, Catholic University of the Sacred Heart, Rome, Italy, and Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: A M
authors.initials: AM
authors.lastname: De Gaetano
authors.affiliation: Department of Bio-Sciences and Radiological Imaging, Catholic University of the Sacred Heart, Rome, Italy, and Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cina
authors.affiliation: Department of Bio-Sciences and Radiological Imaging, Catholic University of the Sacred Heart, Rome, Italy, and Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Di Stasi
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sganga
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Policlinico "A. Gemelli," Largo A. Gemelli, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Agnes
mesh_terms: D000328:Adult; D000792:Angiography / Q000706:statistics & numerical data; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018615:Ultrasonography, Doppler, Color; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology