LIVER-TRANSPLANT REJECTION - VALUE OF HEPATIC VEIN DOPPLER WAVE-FORM ANALYSIS

Background: To determine whether abnormal hepatic vein Doppler tracing s can be used to predict liver transplantation rejection. Methods: A t otal of 158 hepatic Vein Doppler tracings were obtained on 93 postlive r transplant patients (63 patients without rejection and 30 patients w ith biopsy-proven rejection). Hepatic vein Doppler tracings;were score d according to an established grading system (0 = normal triphasic wav eform, 1 = dampened waveform, with loss of flow reversal, 2 = complete ly flat wave form). The hepatic vein Doppler tracings were then correl ated with biopsy findings. Results: In the group of 63 patients withou t rejection, 124 Doppler examinations were performed sind graded as fo llows: 0 = 87 (70%), 1 = 31 (25%), and 2 = 6 (5%). In the group of 30 patients with biopsy-proven rejection, 34 Doppler examinations were pe rformed and graded as follows: 0 = 16 (47%), 1 = 14 (41%), and 2 = 4 ( 12%). The sensitivity of abnormal hepatic vein Doppler tracings for de tection of rejection was 53% and the specificity was 70%. The positive predictive value of an abnormal hepatic vein Doppler tracing was 33% and the negative predictive value of a normal Doppler tracing was 84%. Conclusions: Abnormal hepatic vein Doppler tracings are observed in p atients with and without liver transplant rejection. Abnormal tracings cannot be used to predict liver transplant rejection.