[Ultrasonic diagnosis following liver transplantation]

Realtime and duplex sonography were used routinely for the postoperative and long-term follow-up of liver transplantation patients. In the early postoperative period 90 patients exhibited diffuse (67.7%) and focal (33.3%) alterations of the liver parenchyma; in 53% of patients various liquid lesions were diagnosed in the abdominal cavity. In case of diffuse alterations of the liver parenchyma, no correlation could be established between sonomorphology and histopathologic findings; especially rejection could not be diagnosed by using sonography. In case of focal intrahepatic lesions highly echogenic areas of infarction could be differentiated from poorly echogenic changes such as necrosis, haematoma and abscess--these entities had to be further distinguished by means of CT or needle biopsy. 20 patients showed biliary pathology (biliomas: 5, cholangiectasis: 15). In 73.3% of cholangiectasis the cause of obstruction could be demonstrated sonographically (biliary thrombus, stenosis of the anastomosis of the common bile duct, recurrence of tumour). In 13 patients major vascular complications were diagnosed predominantly by means of duplex sonography (hepatic artery occlusion: 4, hepatic artery stenosis: 1, portal vein occlusion: 1, partial thrombosis of portal vein: 2, portal vein stenosis: 2, stenosis with incomplete thrombosis of the inferior vena cava: 3, VCI stenosis: 1). 13 patients developed recurrent malignancy in the late postoperative period.