Early detection of hepatic artery thrombosis after liver transplantation by Doppler ultrasonography - Prognostic implications

We assessed the usefulness of routine Doppler ultrasonography for early det ection of hepatic artery thrombosis after orthotopic liver transplantation and repercussions in patient prognosis. Seventeen confirmed cases of early hepatic artery thrombosis initially diagnosed by Doppler ultrasonography (1 0 of them before clinical indication) were reviewed. All patients underwent Doppler ultrasonographic studies in the first 3 days after orthotopic live r transplantation. Twelve cases of hepatic artery thrombosis (70.6%) were d etected by this early Doppler ultrasonography. All 10 unsuspected cases of hepatic artery thrombosis and 5 of the 7 cases diagnosed after clinical ind ication were treated by revascularization. Grafts were salvaged in 80% of a symptomatic patients and in 42.8% of symptomatic patients. Furthermore, bil iary complications were less serious in the first group. In conclusion, Dop pler ultrasonography performed routinely in the first 3 days after orthotop ic liver transplantation may permit early detection of hepatic artery throm bosis, even before clinical indications. This allows hepatic artery reperme abilization before liver function damage, improving graft rescue and patien t prognosis.