Harshad Wankhedkar DMRD, Abstract Co-Author: Nothing to Disclose

Sameer Ramchandra Kalgaonkar MD, Presenter: Nothing to Disclose

Barkha Keswani MD, Abstract Co-Author: Nothing to Disclose

VInay Kumaran MChir, Abstract Co-Author: Nothing to Disclose

Ravi Ramakantan MD, Abstract Co-Author: Nothing to Disclose

Charul Goyal MBBS, Abstract Co-Author: Nothing to Disclose

Renu Bharne MBBS, Abstract Co-Author: Nothing to Disclose

Abhisht Aggarwal MBBS, Abstract Co-Author: Nothing to Disclose

Pravin Birangal MBBS, Abstract Co-Author: Nothing to Disclose

Doppler ultrasound aids in the diagnosis of vascular complications in the intra-operative setting, which permits immediate intervention and hence better surgical outcome. The reconstructed vessels are objectively assessed using following Doppler indices: Delayed Systolic Acceleration Time and tardus parvus hepatic artery waveform are strong predictors of hepatic artery stenosis Hepatic artery Resistive Index of <0.6 is the most sensitive predictor of early hepatic artery thrombosis Loss of triphasic hepatic venous waveform is indicative of venous outflow obstruction Intra-operative portal vein flow of >1 liter/min is a predictor of allograft and patient survival  Intraoperative portal venous flow if >500ml/100g/min may require splenic artery ligation or creation of a shunt and if <100ml/100gm/min may require collateral ligation  

I. Indications II. Scanning technique - Sterile preparation for intraoperative scanning - Optimization of doppler parameters III. What the surgeon wants to know 1. Hepatic arterial flow and doppler indices - Resistive Index - Peak Systolic Velocity - Systolic Acceleration Time 2. Hepatic Venous waveform 3. Portal Venous flow - Time Averaged Maximum Velocity & Flow Volume - Inflow modulation

http://abstract.rsna.org/uploads/2014/14016747/14016747_2qr4.pdf

Wankhedkar, H, Kalgaonkar, S, Keswani, B, Kumaran, V, Ramakantan, R, Goyal, C, Bharne, R, Aggarwal, A, Birangal, P, Intra-operative Doppler Ultrasound in Liver Transplant: What the Surgeon Wants to Know.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016747.html