Wade Christian Hedegard MD, Presenter: Nothing to Disclose

Shweta Bhatt MBBS, Abstract Co-Author: Nothing to Disclose

Wael A. Saad MBBCh, Abstract Co-Author: Nothing to Disclose

Deborah J. Rubens MD, Abstract Co-Author: Nothing to Disclose

Vikram Singh Dogra MD, Abstract Co-Author: Nothing to Disclose

To determine the significance of inability to visualize one or more hepatic arteries on spectral Doppler ultrasound analysis performed in the first ten days post liver transplantation.

645 patients (581 cadaveric and 64 living donors) were retrospectively followed up to 1 year post-transplantation. Spectral Doppler waveforms of the hepatic arteries were analyzed on all exams performed within the first ten days. The hepatic artery waveforms were categorized as normal, abnormal, not visualized, or RI<0.5. The abnormal category included both absence and reversal of diastolic flow. Hepatic artery waveforms were then correlated with patient outcomes within one year.   

43/645 patients had non-visualization of a hepatic artery within the first 10 days post-transplant. 23/43 patients developed hepatic artery stenosis, confirmed by angiography or intraoperative evaluation, within the first year. Of the 248 patients with normal waveforms on initial ultrasound examinations, 12 developed hepatic artery stenosis within the first year. Odds Ratio = 22.617. 95% CI (9.823, 52.074). Of the 120 patients with RI < 0.5, 10 had hepatic artery stenosis within the first year. Odds Ratio = 12.65. 95% CI (5.236, 30.564)

Nonvisualization of a hepatic artery on spectral Doppler ultrasound performed in the first 10 days post-liver transplantation has much higher incidence of hepatic artery stenosis than normal or low resistive index waveforms.  

Non-visualization of the heptic artery in a patient with  liver transplant is usually secondary to occlusion rather than presumed technical factors.

Hedegard, W, Bhatt, S, Saad, W, Rubens, D, Dogra, V, Nonvisualization of Hepatic Arteries on Post-transplant Doppler Ultrasound: Technical Limitation or Real?.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6017675.html