Ruolo diagnostico dell’US color Doppler nel I anno di follow-up posttrapianto epatico (OLT)

Abstract

Purpose. This paper discusses the role of colour Doppler ultrasound (CDUS) in the midterm follow-up of patients after orthotopic liver transplantation (OLT). Materials and methods. We retrospectively studied 134 patients -102 men and 32 women, age range 21-68 years -who underwent liver transplantation between May 2006 and April 2007. In the first week after OLT, CDUS examination was performed daily in patients with anastomoses at a high risk of thrombosis, and on the basis of clinical and laboratory findings in other patients. After discharge, follow-up was performed 1, 3, 6 and 12 months after transplantation. Any new parenchymal focal lesion was studied by computed tomography (CT) and, where needed, biopsy. Results. CDUS identified the following complications: 22 biliary (B), nine vascular (V) and seven focal lesions (FL). Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were, respectively: 79.2%, 97.3%, 86.3%, 95.5%, 94% (B), 100%, 99.2%, 88.9%, 100%, 99.3% (V) and 100%, 96.9%, 42.8%, 100%, 97% (FL). CDUS also showed 16 blood collections and eight suspected biliary collections (four of which were confirmed by percutaneous puncture). Conclusions. CDUS is an essential diagnostic tool in the follow-up of OLT. An early diagnosis of complications can improve graft integrity and patient survival. (LF). Sensibilità, specificità, valore predittivo positivo, valore predittivo negativo ed accuratezza diagnostica dell'indagine sono stati rispettivamente: 79,2%, 97,3%, 86,3%, 95,5%, 94% (B), 100%, 100%, 100%, 100%, 100% (V) e 100%, 96,9%, 42,8%, 100%, 97% (LF) Keywords