The Normal Variation in Hepatic Venous Doppler Waveform Post Living Donor Liver Transplant

Normal Variation in Hepatic Venous Doppler Waveform

Abstract

Background: Due to the lack of cadaveric livers, particularly in our part of the world, living donor liver transplantation (LDLT) is commonly being performed. Graft failure and the outcome of surgery are most commonly impacted by vascular complications, including thrombosis and stenosis. Ultrasonography (US), including doppler assessment, has emerged as the initial imaging modality of choice for early detection and follow-up screening of vascular complications.

Methodology: This is a retrospective cohort study. It was conducted at Pakistan Kidney and Liver Institute and Research Centre (PKLI) from 01/07/2021 to 31/12/2021. All adult patients above 16 years of age who underwent LDLT were included. Doppler waveform of the hepatic vein was documented intraoperatively and then for 5 consecutive days. Subsequent scans were performed at 2 weeks, 4 months, and 6 months after transplant. Statistical analysis was performed on SPSS version 20.

Results: Ninety one patients included in the study, the minimum age was 17 years and the maximum age was 73 years. The mean age was calculated to be 45 years. About 79% were males and 21% were females. All patients had hepatofugal flow. The hepatic venous waveforms were quite variable, mostly fluctuating between triphasic and biphasic waveforms.

Conclusion: A whole spectrum of waveforms was noted, of which the triphasic pattern was most common. Both biphasic and monophasic patterns were also encountered and were of no predictive value in terms of significant impact on clinical outcomes.

Keywords: Living donor living transplant (LDLT), Doppler ultrasound, Hepatic vein.