Changes in hepatic hemodynamics after orthotopic liver transplantation: color Doppler sonography

Background: Liver perfusion has an influence on therapy results in patients undergoing orthotopic liver transplantation (OLT). The objective of the pr esent study was to investigate changes in hepatic hemodynamics in patients after OLT with color-coded Doppler sonography (CCDS). Methods: Forty-five consecutive patients were included. The examinations we re done before, on postoperative day 1, and then weekly until the patients were discharged. Mean velocity of the portal (PV-V) and splenic (SV-V) vein s and the maximum velocity and resistance index of the hepatic artery were determined. Results: After OLT a significant increase in PV-V and SV-V was observed. Tw enty-five patients had normal perfusion of the hepatic artery, whereas 16 p atients had abnormal flow patterns. In these patients prostaglandin I-2 was used until flow rates normalized. In four patients, CCDS could not detect perfusion of the hepatic artery. Conclusions: CCDS is a suitable method for evaluating hepatic hemodynamics before and after OLT. Changes in blood flow velocities in the liver-supplyi ng vessels are detectable, but perfusion of the hepatic artery is seldom de tectable. These observations are of special interest after OLT, where liver circulation has an influence on therapy results.