Doppler ultrasonography and contrast-enhanced ultrasonography to evaluate liver allograft discard: A pilot prospective study

Abstract

BACKGROUND: Broad hemodynamic changes, is believed to have a profoundly damaging effect on donor livers after brain death (DBD) or cardiac death (DCD). It remains unclear whether Doppler ultrasonography (DUS) and contrast-enhanced ultrasonography (CEUS), the imaging modalities to evaluate perfusion, could provide more information of liver discarded. OBJECTIVE: To evaluate the ability of DUS and CEUS to predict the risk of DBD or DCD liver discarded. METHODS: The consecutive DBD or DCD donors with DUS/CEUS examinations before surgical procurement from February 2016 to June 2018 at our institution were included. The US and CEUS images of each donor liver were analyzed and the parameters were recorded. RESULTS: Among the 67 eligible donor livers, 15 (22.4%) were discarded and 52 (77.6%) were used. The discarded livers showed prolonged SAT of hepatic artery (0.08s vs 0.06s, OR = 2.169, P = 0.008) on DUS, less cases with homogeneous enhancement (40.0% vs 73.1%, OR = 0.243, P = 0.028) on CEUS, more cases with decreased enhancement (46.7% vs 15.4%, OR = 4.813, P = 0.011), and less difference of the peak time between portal vein and liver parenchymal (0.5s vs 6.7s, OR = 4.260, P = 0.015). The multivariable analysis showed that donor liver with prolonged SAT of hepatic artery (OR = 7.304, 95% CI: 1.195–44.655, P = 0.031) and decreased enhancement (OR = 2.588, 95% CI: 1.234–5.426, P = 0.012) were independent factors of liver discarded. CONCLUSIONS: DUS/CEUS could be applied as a promising predictive tool to screen high-risk liver donors. The prolonged SAT of hepatic artery on DUS and the decrease of liver donor in enhancement on CEUS, indicating hemodynamic changes in DBD and DCD donor livers, were risk factors of liver discarded.

Wireless handheld focused ultrasound in student teaching during the COVID-19 pandemic: Initial results of a pilot study1

“…Further development of this technology, such as by integrating CEUS, Elastography, a pulse-wave mode or power-Doppler, could further increase the application potential [1]. In comparison with the high-end devices, the VScan Air is therefore currently still inferior in these points [15][16][17].…”

Wireless point-of-care ultrasound: First experiences with a new generation handheld device

“…However, since no Doppler spectral analysis, no elastography and no contrast enhanced ultrasound technology is integrated in the present mobile ultrasound devices, high-end ultrasound remains the imaging technique that allows an even more detailed analysis of abdominal and pulmonary pathologies including the evaluation of microcirculation, as current studies show [12][13][14][15][16]. Nevertheless, under the premise of proper training, POCUS shows advantages in fast and critical situations or in intensive care units.…”

Assessment of renal quality with quantitative contrast-enhanced ultrasound (CEUS) for differentiating kidney histopathology before procurement

“…In a recent investigation on donor livers, 67 were examined using CEUS before surgical procurement. Of these,15 livers (22.4%) were discarded, while 52 (77.6%) were deemed transplantable 20 . According to multivariate analysis, a decrease in enhancement (OR = 2.588, 95% CI: 1.234-5.426, P = 0.012) was an independent factor for liver discard.…”