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The objective of this study is to determine whether hepatic artery Doppler ultrasound parameters can predict arterial complications in the immediate period after a liver transplantation in children.A retrospective review of the pediatric liver database at our tertiary-care pediatric hospital was performed. The study included 57 pediatric patients who underwent liver transplantation from 2016 to 2020. Clinical, laboratory and Doppler findings were recorded daily the first 5 days after transplantation. Especial attention was focused on extrahepatic post-anastomotic Peak Systolic Velocity (PSV) and intrahepatic Resistive Index (RI). Forty-nine liver transplant recipients were analyzed. Patients with acute hepatic artery complications, including acute thrombosis and stenosis, had lower PSV values at 3 and 4 days after surgery compared to the group with non-complications, with a statistical significance (p=.015). Receiver operating characteristic (ROC) curve analysis determined an optimal cut-off value of PSV less than 30 cm/s to discriminate children with and without acute hepatic arterial complications, which is lower than that proposed in adults. It correlates with acute arterial stenosis and thrombosis in children even before RI, clinical symptoms or laboratory anomalies appear.

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