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Evaluation of Pediatric Liver Transplantation-Related Artery Complications Using Intra-Operative Multi-Parameter
Xiuyun Ren1,2, Junhui Guan2, Nong Gao2
1Department of Ultrasound, The General Hospital of Chinese People's Liberation Army, Beijing, China (mainland).
Insights
Multi-parameter intraoperative ultrasonography effectively detects pediatric liver transplant arterial complications. Key indicators like hepatic artery diameter and blood flow volume help in timely diagnosis and management.
Area of Science:
- Vascular Surgery
- Pediatric Transplantation
- Diagnostic Imaging
Background:
- Hepatic artery complications are a significant concern in pediatric liver transplantation.
- Early detection and management are crucial for successful outcomes.
Purpose of the Study:
- To evaluate the efficacy of multi-parameter intraoperative ultrasonography in identifying arterial complications following pediatric liver transplantation.
- To identify key ultrasonic parameters indicative of these complications.
Main Methods:
- Sixty-eight pediatric liver transplant recipients underwent intraoperative ultrasonography.
- Measurements included hepatic artery (HA) diameter, anastomotic stoma diameter, peak systolic velocity (PSV), resistance index (RI), acceleration time (SAT), and blood flow volume.
- Comparison of parameters between patients with and without complications, and pre- and post-treatment.
Main Results:
- Significant differences in HA diameter, anastomotic stoma diameter, PSV, RI, SAT, and blood flow volume were observed in the complications group post-treatment.
- Seven recipients experienced postoperative complications.
- Intraoperative parameters (HA diameter, anastomotic stoma diameter, RI, blood flow volume) showed statistically significant differences between complication and no-complication groups (P<0.05).
Conclusions:
- Multi-parameter intraoperative ultrasonography provides a reliable method for diagnosing hepatic artery complications in pediatric liver transplant patients.
- Hepatic artery diameter, anastomotic stoma diameter, PSV, RI, SAT, and blood flow volume are critical for assessing intraoperative arterial complications.
Abstract:
BACKGROUND This article discusses the value of using multi-parameter evaluation of intra-operative ultrasonography in evaluating pediatric liver transplantation-related arterial complications. MATERIAL AND METHODS Sixty-eight children receiving a liver transplant underwent intraoperative ultrasonography for monitoring of artery hemodynamics. The ultrasonic measurement parameters included the diameters of the hepatic artery (HA) of the donor and anastomotic stoma, peak systolic velocity (PSV), resistance index (RI), acceleration time (SAT), and blood flow volume. RESULTS After being treated immediately using surgery or other means, blood flow returned to normal in 8 cases, and did not in 3 cases, of whom 2 experienced postoperative HAT. There was a significant difference in HA diameter of the donor, anastomotic stoma diameter, PSV, RI, SAT, and blood flow volume before and after treatment of the donor in the complications group. Postoperative complications occurred in 7 of 68 recipients, including the 2 cases exhibiting complications during the surgery (complication group) and 5 without complications during the surgery (no complication group). There was a statistically significant difference (P<0.05) between the 2 groups in intraoperative ultrasonography parameters of HA diameter, anastomotic stoma diameter, RI, and blood flow volume. CONCLUSIONS Through intraoperative multi-parameter ultrasonic measurement, a definite diagnosis of hepatic artery complications can be made in liver transplantation patients. HA diameter of the donor, anastomotic stoma diameter, PSV, RI, SAT, and blood flow volume are important in assessing intraoperative artery complications.
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