DUPLEX SONOGRAPHY AFTER ORTHOTOPIC LIVER- TRANSPLANTATION - FINDINGS IN 44 PATIENTS

In a prospective study, 44 patients (11 women, 33 men) who had receive d orthotopic liver transplants underwent a total of 196 consecutive du plex Doppler ultrasound examinations. The aim of the study was to eval uate the correlation between the pulsatile flow index (PFI) and the da mping index (DI) as far as complications as rejection or cholangitis w ere concerned. The patients were examined five times each on average. The PFI and DI were measured in the hepatic artery, the portal vein an d the hepatic veins. The findings were compared with the clinical cour se (cholangitis, rejection) and the histomorphological diagnosis as de termined in biopsy specimens. In biopsy-proven rejection episodes, the sensitivity of the PFI in the hepatic artery was 69.4%, the specifici ty 72.2%. The sensitivity of the DI in the hepatic vein was 89.4%, the specificity 89.1%. Combining the two, specificity was more than 90%. PFI and DI in the portal vein bore no apparent relation to clinical co urse or histomorphological diagnosis. We found duplex Doppler ultrasou nd extremely beneficial in determining the timing and indication for l iver biopsy. In addition, this simple examination, which can be perfor med as often as desired, accurately shows the transplanted liver's res ponse to measures taken to counter rejection.