XXXX in living related liver transplantation detected with intraoperative and postoperative Doppler US.

@entity1 @entity455 @entity254 @entity3181 @entity715 @entity6315
BACKGROUND/AIMS: The purpose of this study was to clarify changes in the graft hemodynamics induced by @entity455 in living related liver transplantation. METHODS: This study included 46 pediatric recipients who underwent partial liver transplantation from living related donors. The blood flow was evaluated in the portal system, the hepatic artery and the hepatic vein with serial intra- and post-operative Doppler ultrasound (US). RESULTS: In 12 @entity1 , intraoperative Doppler US showed a decrease in portal venous inflow (< 9 ml.min-1.kg-1) toward the liver graft and could act as a guide for ligation of collaterals in seven @entity1 , portal re-construction in two, thrombectomy in one and relief of @entity3181 in two for increasing the portal venous inflow. In five @entity1 , intraoperative Doppler US showed poor arterial inflow, i.e. dampened arterial waveforms which involved both low pulsatility index (< 0.90) and low peak-systolic velocity (< 31 cm/s). In three of them, the waveform was more pulsatile after re- @entity254 or relief from stretching of the hepatic artery. The remaining two @entity1 developed @entity715 . Most of the @entity3181 (four of five @entity1 ) had flat waveforms, low flow velocity (< 10 cm/s) of the hepatic vein, and poor portal inflow (flow velocity < 14 cm/s). Postoperative Doppler US showed @entity3181 in three @entity1 , @entity715 in three (twice in one @entity1 ), @entity6315 in two and portal vein @entity715 in one. These complications were successfully managed with surgical procedures in three @entity1 , transhepatic angioplasty in three and conservative treatments in four. Six @entity1 died of @entity455 . CONCLUSIONS: Serial intra- and post-operative Doppler US was a useful technique for making an early diagnosis of abnormal hemodynamics of the graft circulation. Furthermore, intraoperative Doppler US could assess reconstructed vessels objectively and would reduce the incidence of @entity455 following transplantation.
