Doppler Ultrasound Velocities and Resistive Indexes Immediately After Pediatric Liver Transplantation: Normal Ranges and Predictors of Failure

Abstract

Flow in a pediatric liver on the first day after transplantation is normally hyperdynamic, especially in the youngest transplant recipients, and, as a result, low velocities or resistive indexes are particularly concerning for complications. The pediatric-specific ranges of expected posttransplantation Doppler ultrasound findings presented in this article should assist in identifying normal variation and potentially life-threatening complications.

Surgical anterior cavoplasty for managing a case of early acute outflow obstruction after liver transplantation

“…Sonography is normally the first test used for diagnosis of HVOO, although its low sensitivity precludes an accurate diagnosis, which must be confirmed with venography and manometry. In our case, the main indicator for HVOO was an alteration in the arterial Doppler signal, as the intrahepatic signal disappeared and the extrahepatic RI simultaneously showed abnormal values .…”

Evaluation of Pediatric Liver Transplantation-Related Artery Complications Using Intra-Operative Multi-Parameter Ultrasonography

“…Generally, scholars believe that disappeared blood flow of the hepatic artery, reduced RI, prolonged SAT, and tardus-parvus waveform are the major evidence for predicting hepatic artery stenosis and thrombosis using ultrasonography [14]. In addition, we also pay attention to thrombogenesis from intraoperative hypotension-induced decrease of arterial blood flow, as well as false-positive results of ultrasonography at the early postoperative phase due to intraoperative edema and spasm in the hepatic artery [15]. Some scholars reported that SAT and tardus-parvus waveforms were associated with stenosis, but RI was not related to PSV; the sensitivity, specificity, and negative predictive values of Doppler ultrasonography were 60.0%, 73.7%, and 84.9% using tardus-parvus waveform as the evaluation factor, and 40.0%, 83.6%, and 80.9%, respectively, with prolonged SAT [16].…”

Pediatric En Bloc Kidney Transplants: Clinical and Immediate Postoperative US Factors Associated with Vascular Thrombosis

“…Our findings are, however, supported by the liver transplantation literature. Authors of a recent study (21) of immediate postoperative US on recipients of pediatric liver transplant also found that decreased arterial velocity and lower RIs were associated with impending hepatic arterial thrombosis. An additional four of six cases results are consistent with these prior findings, because increased thrombosis was seen with lower donor weight.…”