Variation of Normal Portal Venous Doppler Indices in Post-Operative Period following Living Donor Liver Transplant.

Abstract

Background:

Liver transplant is the treatment of choice for irreversible acute liver failure and end-stage chronic liver disease. Patient prognosis in the early pot-operative phase is most adversely impacted by vascular complications. The most appropriate tool for assessing vascular patency is ultrasound. Hence, it is of utmost importance that radiologists are able to recognize acceptable variations in normal Doppler indices to prevent false alarms. This article describes normal variations in post-operative doppler assessment of the portal vein.

Materials and Methods:

This retrospective cohort study was carried out at Pakistan Kidney and Liver Institute and Research Centre from July 1 to December 31 2021. It included all adult patients over 16 years of age who underwent Living Donor Liver Transplant (LDLT). Triplex Doppler ultrasound of LDLT recipients was performed intraoperatively and postoperatively for 5 consecutive days. Subsequent scans were performed at 2 weeks, 4 months, and 6 months after the transplant. Portal vein velocities were taken at the extrahepatic part, anastomosis, and intrahepatic part. Statistical analysis was performed using SPSS version 20.

Results:

We had 91 patients. The minimum age was 17 years, the maximum age was 73 years, and the mean age was 44.9 years. 79% of the recipients were males and 21% were females. The portal venous velocities ranged from 31 cm/s to 357 cm/s. All patients had antegrade portal venous flow. The portal venous velocities normalized in 4-6 months following LDLT.

Conclusion:

A wide range of portal venous velocities can be encountered following LDLT without clinically significant outcome and these usually normalize within 4-6 months following LDLT.