JUM etoc signup
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Chen, W.
Right arrow Articles by Rodriguez, M. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Chen, W.
Right arrow Articles by Rodriguez, M. I.
© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:631-638 • 0278-4297

Case Series

Doppler Ultrasonographic Findings on Hepatic Arterial Vasospasm Early After Liver Transplantation

Wei Chen, MD, RDMS, RVT, Marcelo E. Facciuto, MD, Juan P. Rocca, MD, Michael R. Marvin, MD, Patricia A. Sheiner, MD, Susan Rachlin, MD and Manuel I. Rodriguez, MD

Departments of Radiology and Surgery, Westchester Medical Center, Valhalla, New York USA.

Address correspondence to Wei Chen, MD, RDMS, RVT, Department of Radiology, Westchester Medical Center, Valhalla, NY 10595 USA. E-mail: carotid01{at}aol.com

Objective. Hepatic arterial vasospasm has not been well recognized clinically as a post–liver transplant vascular complication because of the lack of sufficient data and diagnostic standards. The goal of this study was to provide new evidence and a diagnostic model for the clinical appreciation of hepatic arterial vasospasm and evaluate the role of ultrasonography in the diagnostic process. Methods. Nine post–orthotopic liver transplant cases were retrospectively reviewed. Multiple clinical measurements were analyzed. Routine Doppler ultrasonography was performed within 24 hours, and additional ultrasonographic examinations were conducted as indicated. Each of the 9 patients was given a single 10 mg dose of nifedipine sublingually and monitored by ultrasonography when vasospasm was suspected on the basis of the Doppler ultrasonographic results. Results. Doppler ultrasonography showed high-resistance hepatic arterial flow with absence of antegrade flow and even reversal of flow during diastole both extrahepatically and intrahepatically in all cases. Ten to 45 minutes after administration of the vasodilator, antegrade diastolic flow was observed along the course of the main hepatic artery and its intrahepatic branches with the resistive indices decreasing on average from 1.0 to 0.76. In addition, the peak systolic velocities increased from 57 cm/s before nifedipine administration to 77 cm/s after administration. Conclusions. High-resistance hepatic arterial flow (resistive index = 1) early after liver transplantation is indicative of hepatic arterial vasospasm if it responds to vasodilators. Doppler ultrasonography is a useful tool for the diagnosis of this vascular complication.

Key Words: Doppler ultrasonography • hepatic artery vasospasm • high-resistance arterial flow • liver transplantation • vasodilator

Abbreviations: DUS, Doppler ultrasonography • HAT, hepatic artery thrombosis • LFT, liver function test • MHA, main hepatic artery • OLT, orthotopic liver transplantation • PSV, peak systolic velocity • RI, resistive index

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Institute of Ultrasound in Medicine.