22 September 2020 : Original article
Intensive Doppler Ultrasonography for Early Detection of Hepatic Artery Thrombosis After Adult Living Donor Liver Transplantation
Pi-Ling Chiang1ABCDEF, Yu-Fan Cheng1ADG, Tung-Liang Huang1BG, Hsin-You Ou1B, Chun-Yen Yu1B, Hsien-Wen Hsu2B, Wei-Xiong Lim2B, Chao-Long Chen3B, Chee-Chien Yong3B, Leo Leung-Chit Tsang1ABDEF*DOI: 10.12659/AOT.924336
Ann Transplant 2020; 25:e924336
Table 1 The demographic and clinical characteristics of adult LDLT recipients with abnormal Doppler flows in different treatment groups.
Medical group (n=5) | Surgical group (n=4) | |||||
---|---|---|---|---|---|---|
n | Mean±SD | Range | n | Mean±SD | Range | |
Gender | ||||||
Male | 5 | 2 | ||||
Female | 0 | 2 | ||||
Age (years) | 55.6±11.1 | 38–66 | 55.0±9.2 | 43–65 | ||
Time of diagnosis of HAT (POD) | 9.2±5.3 | 3–14 | 7.8±4.8 | 1–12 | ||
Serum AST (U/L) | 56.80±11.88 | 40–72 | 201.50±242.21 | 34–548 | ||
Serum ALT (U/L) | 137.20±64.61 | 86–250 | 285.00±326.00 | 57–752 | ||
Serum TB (mg/dL) | 1.56±0.72 | 0.7–2.3 | 2.45±1.75 | 0.6–4.7 | ||
Serum DB (mg/dL) | 0.61±0.42 | 0.3–1.1 | 0.85±0.54 | 0.3–1.6 | ||
Post-LDLT Doppler US of HA | ||||||
Doppler US waveform | 5 | 4 | ||||
Complete absence | 2 | 2 | ||||
Tardus parvus | 3 | 2 | ||||
PSV (cm/second) | 21.83±13.77 | 10.1–37.0 | 28.75±4.17 | 25.8–31.7 | ||
RI | 0.49±0.08 | 0.43–0.58 | 0.56±0.07 | 0.51–0.61 | ||
CTA of intrahepatic HA | ||||||
Patency | 1 | 0 | ||||
Partial occlusion | 4 | 1 | ||||
Total occlusion | 0 | 3 | ||||
Time of discharge (POD) | 5 | 51.2±10.5 | 35–62 | 4 | 174.3±198.2 | 53–403 |
Long-term follow-up | ||||||
Mortality * | 0 | 1 | ||||
Biliary dilatation | 0 | 1 | ||||
Serum TB (mg/dL) | N/A | N/A | 7.5 | N/A | ||
Serum DB (mg/dL) | N/A | N/A | 5.5 | N/A | ||
No biliary complication | 5 | 2 | ||||
Serum TB (mg/dL) | 0.56±0.23 | 0.3–0.8 | 0.60±0.42 | 0.3–0.9 | ||
Serum DB (mg/dL) | 0.14±0.05 | 0.1–0.2 | 0.15±0.07 | 0.1–0.2 | ||
* Mortality case due to internal bleeding and multiorgan failure. ALT – alanine transaminase; AST – aspartate transaminase; DB – direct bilirubin; HA – hepatic artery; HAT – hepatic artery thrombosis; LDLT – living donor liver transplantation; N/A – not applicable; POD – postoperative day; PSV – peak systolic velocity; RI – resistive index; TB – total bilirubin; US – ultrasonography. |