Doppler ultrasonographic findings on hepatic arterial vasospasm early after liver transplantation

Wei Chen, Marcelo E. Facciuto, Juan P. Rocca, Michael R. Marvin, Patricia A. Sheiner, Susan Rachlin, Manuel I. Rodriguez

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective. Hepatic arterial vasospasm has not been well recognized clinically as a post-liver transplant vascular complication because of the lack of sufficient data and diagnostic standards. The goal of this study was to provide new evidence and a diagnostic model for the clinical appreciation of hepatic arterial vasospasm and evaluate the role of ultrasonography in the diagnostic process. Methods. Nine post-orthotopic liver transplant cases were retrospectively reviewed. Multiple clinical measurements were analyzed. Routine Doppler ultrasonography was performed within 24 hours, and additional ultrasonographic examinations were conducted as indicated. Each of the 9 patients was given a single 10 mg dose of nifedipine sublingually and monitored by ultrasonography when vasospasm was suspected on the basis of the Doppler ultrasonographic results. Results. Doppler ultrasonography showed high-resistance hepatic arterial flow with absence of antegrade flow and even reversal of flow during diastole both extrahepatically and intrahepatically in all cases. Ten to 45 minutes after administration of the vasodilator, antegrade diastolic flow was observed along the course of the main hepatic artery and its intrahepatic branches with the resistive indices decreasing on average from 1.0 to 0.76. In addition, the peak systolic velocities increased from 57 cm/s before nifedipine administration to 77 cm/s after administration. Conclusions. High-resistance hepatic arterial flow (resistive index = 1) early after liver transplantation is indicative of hepatic arterial vasospasm if it responds to vasodilators. Doppler ultrasonography is a useful tool for the diagnosis of this vascular complication.

Original languageEnglish (US)
Pages (from-to)631-638
Number of pages8
JournalJournal of Ultrasound in Medicine
Volume25
Issue number5
StatePublished - May 2006
Externally publishedYes

Fingerprint

transplantation
liver
Liver Transplantation
Liver
Doppler Ultrasonography
high resistance
diastole
Nifedipine
Vasodilator Agents
Blood Vessels
Ultrasonography
arteries
Transplants
Diastole
Hepatic Artery
examination
dosage

Keywords

  • Doppler ultrasonography
  • Hepatic artery vasospasm
  • High-resistance arterial flow
  • Liver transplantation
  • Vasodilator

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Acoustics and Ultrasonics

Cite this

Chen, W., Facciuto, M. E., Rocca, J. P., Marvin, M. R., Sheiner, P. A., Rachlin, S., & Rodriguez, M. I. (2006). Doppler ultrasonographic findings on hepatic arterial vasospasm early after liver transplantation. Journal of Ultrasound in Medicine, 25(5), 631-638.

Doppler ultrasonographic findings on hepatic arterial vasospasm early after liver transplantation. / Chen, Wei; Facciuto, Marcelo E.; Rocca, Juan P.; Marvin, Michael R.; Sheiner, Patricia A.; Rachlin, Susan; Rodriguez, Manuel I.

In: Journal of Ultrasound in Medicine, Vol. 25, No. 5, 05.2006, p. 631-638.

Research output: Contribution to journalArticle

Chen, W, Facciuto, ME, Rocca, JP, Marvin, MR, Sheiner, PA, Rachlin, S & Rodriguez, MI 2006, 'Doppler ultrasonographic findings on hepatic arterial vasospasm early after liver transplantation', Journal of Ultrasound in Medicine, vol. 25, no. 5, pp. 631-638.
Chen, Wei ; Facciuto, Marcelo E. ; Rocca, Juan P. ; Marvin, Michael R. ; Sheiner, Patricia A. ; Rachlin, Susan ; Rodriguez, Manuel I. / Doppler ultrasonographic findings on hepatic arterial vasospasm early after liver transplantation. In: Journal of Ultrasound in Medicine. 2006 ; Vol. 25, No. 5. pp. 631-638.
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AU - Sheiner, Patricia A.

AU - Rachlin, Susan

AU - Rodriguez, Manuel I.

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N2 - Objective. Hepatic arterial vasospasm has not been well recognized clinically as a post-liver transplant vascular complication because of the lack of sufficient data and diagnostic standards. The goal of this study was to provide new evidence and a diagnostic model for the clinical appreciation of hepatic arterial vasospasm and evaluate the role of ultrasonography in the diagnostic process. Methods. Nine post-orthotopic liver transplant cases were retrospectively reviewed. Multiple clinical measurements were analyzed. Routine Doppler ultrasonography was performed within 24 hours, and additional ultrasonographic examinations were conducted as indicated. Each of the 9 patients was given a single 10 mg dose of nifedipine sublingually and monitored by ultrasonography when vasospasm was suspected on the basis of the Doppler ultrasonographic results. Results. Doppler ultrasonography showed high-resistance hepatic arterial flow with absence of antegrade flow and even reversal of flow during diastole both extrahepatically and intrahepatically in all cases. Ten to 45 minutes after administration of the vasodilator, antegrade diastolic flow was observed along the course of the main hepatic artery and its intrahepatic branches with the resistive indices decreasing on average from 1.0 to 0.76. In addition, the peak systolic velocities increased from 57 cm/s before nifedipine administration to 77 cm/s after administration. Conclusions. High-resistance hepatic arterial flow (resistive index = 1) early after liver transplantation is indicative of hepatic arterial vasospasm if it responds to vasodilators. Doppler ultrasonography is a useful tool for the diagnosis of this vascular complication.

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