Sonographic evaluation of vessel grafts in living donor liver transplantation recipients of the right lobe

• Published in: World journal of gastroenterology : WJG Vol. 15; no. 28; pp. 3550 - 3554
• Main Authors: Lu, Qiang, Wu, Hong, Fan, Yu-Ting, Luo, Yan, Zhang, Zhong-Wei
• Format: Journal Article
• Language: English
• Published: United States Department of Sonography, West China Hospital, Sichuan University, Chengdu 610041, China%Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, China 28-07-2009; The WJG Press
• Subjects: Adult; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Brief; Female; Hepatic Veins - diagnostic imaging; Humans; Liver Diseases - surgery; Liver Transplantation - diagnostic imaging; Living Donors; Male; Middle Aged; Postoperative Period; Regional Blood Flow; Sensitivity and Specificity; Ultrasonography, Doppler; Vascular Patency; Young Adult; 肝移植; 超声评价; Ultrasound; Vessel graft; Middle hepatic vein; Venous collateral; Living donor liver transplantation
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.15.3550

AIM： To evaluate the vessel grafts （VG） used to reconstruct the middle hepatic vein （MHV） tributaries with ultrasonography. METHODS： Twenty-four patients undergone living donor liver transplantation were enrolled in our study. MHV tributaries larger than 5 mm in diameter were reconstructed with interposition VG. Blood flow of the graft and interposition VG was checked by Doppler ultrasonography daily in the first 2 postoperative weeks and monthly followed up after discharge. The sensitivity of VG detected by ultrasonography was assessed using surgical records as references. Student＇s t test was used to compare the velocity of VG and occluded VG in chronic patents （〉 3 mo）. RESULTS： Thirty-one VG were used to reconstruct the MHV tributaries. Ultrasonography identified 96.7% （30/31） of large MHV tributaries and 90.3% （28/31） of VG. The diameter of VG was 5.6 ± 0.8 mm and the velocity of VG was 19.7 ± 8.1 cm/s. Two VG （2/31, 6.5%） were occluded on the first postoperative day in one patient who suffered from persistent ascites and had a prolonged recovery of liver function. Twenty-six VG （26/31, 83.9%） were patent 2 wk after operation. Six （6/31, 19.4%） VG were patent over 3 mo after operation. Intrahepatic venous collaterals were detected in 29.2% （7/24） patients. The velocity of VG and occluded VG was 30.1 ± 5.6 cm/s, 16.5 ± 5.8 cm/s, respectively, in chronic patents. The difference between two groups was statistically significant （P 〈 0.001）. CONCLUSION： Our results indicate that most VG are patent in the first postoperative week while only a small portion with a higher velocity remains patent after 3 mo. Intrahepatic venous collaterals can be observed in some patients after occlusion of VG.