Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 7, 2009; 15(29): 3670-3675
Published online Aug 7, 2009. doi: 10.3748/wjg.15.3670
CEUS: A new imaging approach for postoperative vascular complications after right-lobe LDLT
Yan Luo, Yu-Ting Fan, Qiang Lu, Bo Li, Tian-Fu Wen, Zhong-Wei Zhang
Yan Luo, Yu-Ting Fan, Qiang Lu, Department of Sonography, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Bo Li, Tian-Fu Wen, Zhong-Wei Zhang, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Luo Y designed the research; Luo Y, Fan YT and Lu Q did the ultrasound examination and collected the data; Li B and Wen TF performed the RLDLT operation; Zhang ZW was responsible for the RLDLT patients in the ICU; Luo Y drafted and revised the manuscript and approved the final version.
Correspondence to: Yan Luo, Professor, Department of Sonography, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. luoyand@hotmail.com
Telephone: +86-28-85423192
Fax: +86-28-85423192
Received: April 18, 2009
Revised: June 17, 2009
Accepted: June 24, 2009
Published online: August 7, 2009
Abstract

AIM: To investigate contrast-enhanced ultrasound (CEUS) for early diagnosis of postoperative vascular complications after right-lobe living donor liver transplantation (RLDLT).

METHODS: The ultrasonography results of 172 patients who underwent RLDLT in West China Hospital, Sichuan University from January 2005 to June 2008 were analyzed retrospectively. Among these 172 patients, 16 patients’ hepatic artery flow and two patients’ portal vein flow was not observed by Doppler ultrasound, and 10 patients’ bridging vein flow was not shown by Doppler ultrasound and there was a regional inhomogeneous echo in the liver parenchyma upon 2D ultrasound. Thus, CEUS examination was performed in these 28 patients.

RESULTS: Among the 16 patients without hepatic artery flow at Doppler ultrasound, CEUS showed nine cases of slender hepatic artery, six of hepatic arterial thrombosis that was confirmed by digital subtraction angiography and/or surgery, and one of hepatic arterial occlusion with formation of lateral branches. Among the two patients without portal vein flow at Doppler ultrasound, CEUS showed one case of hematoma compression and one of portal vein thrombosis, and both were confirmed by surgery. Among the 10 patients without bridging vein flow and with liver parenchyma inhomogeneous echo, CEUS showed regionally poor perfusion in the inhomogeneous area, two of which were confirmed by enhanced computed tomography (CT), but no more additional information about bridging vein flow was provided by enhanced CT.

CONCLUSION: CEUS may be a new approach for early diagnosis of postoperative vascular complications after RLDLT, and it can be performed at the bedside.

Keywords: Contrast-enhanced ultrasound; Living donor liver transplantation; Postoperative complication; Vascular disease