Variation of Normal Hepatic Artery Doppler Indices Post Living Donor Liver Transplant

Abstract

Background:  Due to the lack of deceased donors, adult-to-adult living donor living transplant (LDLT) has emerged as the procedure of first choice among liver transplantation procedures in most Asian countries. Hepatic artery complications can lead to graft ischemia and are one of the most frequent causes of graft loss in the immediate postoperative period. Ultrasonography, including doppler evaluation, is the established initial imaging modality of choice for early detection and follow-up screening of vascular complications.

Materials and Methods: This retrospective cohort study was carried out at the Pakistan Kidney and Liver Institute and Research Centre (PKLI)and spanned from 01/07/2021 to 31/12/2021. Patients above 16 years of age who had undergone LDLT were included. Hepatic artery peak systolic velocities (PSV), resistive indices (RI), and acceleration times (AT) were documented intra operatively and then for 5 consecutive days. Follow-up scans were performed at 2 weeks, 4 months, and 6 months after the transplant. SPSS version 20 was used for statistical analysis.

Results: A total of 91 patients were included in the study. The minimum age was 17 years and the maximum age was 73 years with a mean age calculated to be 45 years. Approximately 79% of patients were males and 21% were females. A PSV of as less as 15 cm/s and as high as 267 cm/s was recorded with normal waveforms. A minimum RI of 0.44 and a maximum of 0.89 was observed. A minimum AT of 0.01 seconds and a maximum of 0.07seconds were noted.

Conclusion: A wide range of hepatic arterial velocities can be encountered following LDLT without clinically significant out comes. The hepatic arterial velocities normalized within 4 to 6 months following LDLT. Hepatic artery RI values of 0.44 to 0.89 can be observed without any complications.