DUPLEX-DOPPLER SONOGRAPHY AND ANGIOGRAPHY IN THE EVALUATION FOR LIVER-TRANSPLANTATION

Duplex Doppler sonography (DDS) and angiography were per formed in a p rospective study comprising 22 adult patients with hepatic failure. Th e ability of the 2 methods to Visualize the different splanchnic Vesse ls was compared, as well as any abnormality in the liver parenchyma an d vessels. The purpose of the study was to decide if DDS could replace angiography in the pretransplantation work-up in these patients. The portal vein was correctly identified as open in 20 patients using DDS and in 21 patients at angiography. Portal Vein thrombosis in one patie nt was correctly diagnosed by both methods. The identification of othe r vascular structures in the upper part of the abdomen, e.g., liver ar teries and splenic vein, was demonstrated in 14 and 16 patients respec tively at DDS. Hepatoma in one patient was correctly identified by bot h methods, as well as the presence of ascites. Splenic artery aneurysm s were found in 4 patients at angiography, and in none of these was DD S able to show this abnormality. We conclude that abdominal angiograph y still seems superior to DDS in the evaluation of patients with hepat ic failure prior to orthotopic liver transplantation, especially to de monstrate possible splenic artery aneurysms and detailed mapping of th e hepatic arteries.