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Journal of Ultrasound in Medicine, Vol 20, Issue 1 51-58, Copyright © 2001 by American Institute of Ultrasound in Medicine
Early detection of hepatic artery thrombosis after liver transplantation by Doppler ultrasonography: prognostic implications
A. Garcia-Criado, R. Gilabert, C. Nicolau, I. Real, P. Arguis, L. Bianchi, R. Vilana, J. M. Salmeron, J. C. Garcia-Valdecasas and C. Bru
Diagnosing Imaging Center, Institut de Malaties Digestives, Clinic Hospital, Barcelona, Spain.
We assessed the usefulness of routine Doppler ultrasonography for early
detection of hepatic artery thrombosis after orthotopic liver
transplantation and repercussions in patient prognosis. Seventeen confirmed
cases of early hepatic artery thrombosis initially diagnosed by Doppler
ultrasonography (10 of them before clinical indication) were reviewed. All
patients underwent Doppler ultrasonographic studies in the first 3 days
after orthotopic liver transplantation. Twelve cases of hepatic artery
thrombosis (70.6%) were detected by this early Doppler ultrasonography. All
10 unsuspected cases of hepatic artery thrombosis and 5 of the 7 cases
diagnosed after clinical indication were treated by revascularization.
Grafts were salvaged in 80% of asymptomatic patients and in 42.8% of
symptomatic patients. Furthermore, biliary complications were less serious
in the first group. In conclusion, Doppler ultrasonography performed
routinely in the first 3 days after orthotopic liver transplantation may
permit early detection of hepatic artery thrombosis, even before clinical
indications. This allows hepatic artery repermeabilization before liver
function damage, improving graft rescue and patient prognosis.
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