Role of Doppler Ultrasonography in Defining Normal and Abnormal Graft Hemodynamics After Living-Donor Liver Transplant.

OBJECTIVES: Our aim was to investigate the early changes that occur after graft perfusion in living-donor liver transplant by Doppler ultrasonography.

MATERIALS AND METHODS: We prospectively evaluated liver grafts of 30 patients who underwent living-donor liver transplant during an 18-month period and who were followed for 1 year postoperatively. The hepatic artery peak systolic velocity, resistivity index, portal vein velocity, portal vein anastomotic velocity ratio, and hepatic vein pattern were compared after excluding patients who developed vascular complications and acute rejection episodes.

RESULTS: We observed intraoperative increases in the mean hepatic artery peak systolic velocity (96.3 ± 65 cm/s), the resistivity index (0.78 ± 0.091), and the portal vein velocity (99.6 ± 48 cm/s), which started to normalize after 2 weeks. In comparing the mean portal vein velocity, portal vein anastomotic velocity ratio, hepatic artery peak systolic velocity, and resistivity index after excluding 5 patients who developed vascular complications, we observed overall significance levels of P < .001, P = .039, P < .001, and P = .040. After we excluded 9 patients who developed acute rejection, our comparison of the portal vein velocity, hepatic artery peak systolic velocity, and resistivity index showed overall significance (P < .001, P < .001, and P = .043).

CONCLUSIONS: Early and transient increases in portal vein velocity, anastomotic velocity ratio, hepatic artery peak systolic velocity, and resistivity index are common after living-donor liver transplant, with significant declines in the first 2 weeks posttransplant.