Color Doppler ultrasound findings of hepatic artery in patients with biliary complications after liver transplantation

Abstract

Objective To investigate the relation between hepatic arterial abnormity and biliary complications after liver transplantation with the use of color Doppler ultrasonography. Methods Clinical data of 98 patients undergoing liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University from October 2004 to October 2013 were analyzed retrospectively. According to whether the patients suffered from biliary complications after liver transplantation, they were divided into biliary complication group and non-biliary complication group. There were 52 cases in biliary complication group [49 males,3 females, mean age:(49±24) years old]. There were 46 cases in non-biliary complication group [41 males, 5 females, mean age:(46±29) years old]. The informed consents of all patients were obtained and local ethical committee approval had been received. Color Doppler ultrasonography was performed to examine the liver graft 90 d after liver transplantation and the blood flow parameters of intra-, extrahepatic bile duct and hepatic artery were observed. The comparison of blood flow parameters between two groups was conducted using t test. The comparison of incidence of hepatic arterial abnormity was conducted using Chi-square test. Results In biliary complication group, hepatic artery stenosis was observed in 6 cases, hepatic artery thrombosis in 3 cases and hepatic artery stenosis combined with intrahepatic arteriovenous fistula in 1 case. The incidence of hepatic arterial abnormity was 19% (10/52), which was significantly higher than that in non-biliary complication group [2% (1/46)] (χ2=24.96, P<0.05). The maximum velocity of the proper hepatic artery in biliary complication group [(90±21) cm/s] was significantly higher than that in non-biliary complication group [(67±17)cm/s] and the resistance index of intrahepatic artery in biliary complication group (0.55±0.14) was significantly lower than that in non-biliary complication group (0.64±0.08) (t=9.74, -16.96; P<0.05). Conclusions Biliary complications after liver transplantation are associated with hepatic arterial abnormity. Monitoring the hemodynamic variation of hepatic artery after liver transplantation with color Doppler ultrasonography helps to diagnose the biliary complications early. Key words: Liver transplantation; Postoperative complications; Ultrasonography, Doppler, color; Biliary tract diseases