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Duplex Doppler detection of hepatic artery thrombosis following liver transplantation
R M Wellings1, S P Olliff, J F Olliff
1Department of Diagnostic Radiology, Queen Elizabeth Hospital, Birmingham.
Insights
Duplex Doppler ultrasound effectively detects hepatic artery thrombosis after liver transplants. This non-invasive method accurately identifies patients needing further angiography for potential arterial issues.
Area of Science:
- Transplantation Surgery
- Vascular Imaging
- Gastroenterology
Background:
- Hepatic artery thrombosis (HAT) is a significant complication following liver transplantation.
- HAT contributes to substantial morbidity and mortality in transplant recipients.
- Early detection of HAT is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the diagnostic accuracy of prospective duplex Doppler ultrasound for detecting hepatic artery thrombosis.
- To assess the utility of duplex Doppler ultrasound in identifying liver transplant recipients requiring further vascular investigation.
Main Methods:
- Prospective study of 100 consecutive liver transplants in 90 patients.
- Duplex Doppler ultrasound was used to assess hepatic artery patency.
- Angiography was performed for abnormal ultrasound findings.
Main Results:
- Duplex Doppler ultrasound correctly identified all 10 confirmed cases of hepatic artery thrombosis.
- No hepatic artery thrombosis was detected in patients with normal duplex Doppler studies.
- Abnormal ultrasound findings correlated with arteriographic evidence of hepatic artery occlusion, stenosis, or narrowing.
Conclusions:
- Duplex Doppler ultrasound is a practical and sensitive tool for diagnosing hepatic artery thrombosis post-liver transplant.
- This imaging modality effectively selects patients for confirmatory angiography.
- Utilizing duplex Doppler ultrasound can improve the management of post-transplant hepatic artery complications.
Abstract:
Hepatic artery thrombosis is a major cause of morbidity and mortality following liver transplantation. We assessed the value of prospective duplex Doppler ultrasound in detecting hepatic artery thrombosis. One hundred consecutive transplants in 90 patients were studied. Duplex Doppler detected all 10 proven cases of hepatic artery thrombosis. No case of hepatic artery thrombosis was found with a normal duplex study. All arteriograms performed following an abnormal ultrasound demonstrated hepatic arterial occlusion or anastomotic stenosis or a segment of irregular arterial narrowing. We conclude that duplex Doppler is a practical and sensitive method of selecting patients with a presumptive diagnosis of hepatic artery thrombosis for further investigation by angiography.
