Orthotopic liver transplantation: Reversible Doppler US findings in the immediate postoperative period

Rupan Sanyal, Chandana G. Lall, Ramit Lamba, Sadhna Verma, Shetal N. Shah, Temel Tirkes, William A. Berry, Kumar Sandrasegaran

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Orthotopic liver transplantation (OLT) is the only definitive treatment for irreversible acute liver failure and chronic liver disease. In the immediate postoperative period after OLT, patients are closely monitored with Doppler ultrasonography (US) to detect treatable vascular complications and ensure graft survival. The first postoperative Doppler US examination is performed fairly early on the first postoperative day, before surgical wound closure has been performed. The immediate postoperative images, obtained when the effects of surgery are very recent, often reveal an array of findings that may appear alarming but that tend to normalize within a few days and are compatible with changes related to the surgery itself. These findings include a starry-sky appearance of reperfusion hepatic edema, transient foci of increased echogenicity, pneumobilia, small fluid collections, perihepatic hematomas, pleural effusion, temporary elevation of hepatic arterial velocity, transient elevation of resistive index (RI), decreased RI with tardus parvus waveform, increased portal venous flow and mono- or biphasic waveforms of the hepatic veins. Most of these changes revert to normal in the first postoperative week; deterioration atypical of transient changes requires further evaluation.

Original languageEnglish
Pages (from-to)199-211
Number of pages13
JournalRadiographics
Volume32
Issue number1
DOIs
StatePublished - Jan 2012

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Doppler Ultrasonography
Postoperative Period
Liver Transplantation
Hepatic Veins
Acute Liver Failure
Liver
Graft Survival
Pleural Effusion
Hematoma
Reperfusion
Blood Vessels
Liver Diseases
Edema
Chronic Disease
Therapeutics
Surgical Wound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Orthotopic liver transplantation : Reversible Doppler US findings in the immediate postoperative period. / Sanyal, Rupan; Lall, Chandana G.; Lamba, Ramit; Verma, Sadhna; Shah, Shetal N.; Tirkes, Temel; Berry, William A.; Sandrasegaran, Kumar.

In: Radiographics, Vol. 32, No. 1, 01.2012, p. 199-211.

Research output: Contribution to journalArticle

Sanyal, Rupan ; Lall, Chandana G. ; Lamba, Ramit ; Verma, Sadhna ; Shah, Shetal N. ; Tirkes, Temel ; Berry, William A. ; Sandrasegaran, Kumar. / Orthotopic liver transplantation : Reversible Doppler US findings in the immediate postoperative period. In: Radiographics. 2012 ; Vol. 32, No. 1. pp. 199-211.
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