Routine intraoperative Doppler sonography in the evaluation of complications after living‐related donor liver transplantation

Abstract

Delayed SAT of the hepatic artery and loss of triphasity of the hepatic vein had a >80% for specificity for predicting vascular complications. Tardus-parvus pattern, delayed SAT of the hepatic artery, and loss of triphasity of the hepatic vein showed an acceptable NPV for identifying vascular complications.

Imaging in liver transplantation

“…In partial liver transplants, hepatic vein stenosis is a frequent complication. CDUS of the hepatic veins reveals a slow (< 10 cm/s) and monophasic flow [44,46,49] . All the vascular complications described, when suspected on US and CDUS, need confirmation with contrast-enhanced MDCT, contrast-enhanced MR or with angiography.…”

“…During transplantation, CDUS is usually performed to detect the intraparenchymal flows (arterial, portal and venous), and to evaluate the velocity of flow and waveform to detect very early complications such as hyperacute hepatic artery or PVT [44] . After LT, CDUS is usually performed once a day during the first week, and once a week in the following 2 mo, and is key in the suspicion or identification of vascular or biliary complications.…”

“…Post-liver transplant stenosis of the inferior vena cava is rare and generally secondary to technical issues. CDUS shows an increased trans-anastomotic velocity gradient (> 4 times) and the loss of the tracing's normal phasicity [44,46,49] (Figure 8). In partial liver transplants, hepatic vein stenosis is a frequent complication.…”

Evaluation of standard liver volume formulae for Chinese adults

“…Right liver g raft without middle hepatic vein reconstruction from a living donor was performed as described, with temporary occlusion of the right portal vein (PV) and right hepatic artery and use of ultrasonography to guide parenchymal transection. The right hepatic duct, right hepatic artery, right portal vein branch, and right hepatic vein were transected approximately 2-3 mm from the confluence [19,20] , leaving the donor's main PV and confluence intact. The graft was flushed with University of Wisconsin solution through the PV and hepatic artery [21,22] .…”

Evaluation of the hepatic artery anastomosis by intraoperative sonography with high‐frequency transducer in right‐lobe graft living donor liver transplantation

“…1 The role of Doppler sonography (US) as a screening modality cannot be overemphasized in the noninvasive evaluation of the graft HA flow, and a unique advantage of this method is that it can be performed intraoperatively, providing an immediate assessment of the vascular patency so that the surgeon has an opportunity to decide on a timely and appropriate management. [2][3][4] Previous reports using intraoperative sonography (IOUS) showed that the patency of the HA anastomosis could be determined by quantitative and qualitative assessment of Doppler signals from the graft HA that reflect hemodynamic changes across the anastomosis. [2][3][4] To our knowledge, however, the morphologic assessment of the HA anastomosis on IOUS has not been made; it may have been most likely due to a difficulty in visualization of the HA anastomosis on low-frequency IOUS (1)(2)(3)(4).…”