Doppler Ultrasound of Vascular Complications After Pediatric Liver
                    Transplantation: Incidence, Time of Detection, and Positive Predictive
                    Value

Martijn V. Verhagen; Ruben H.J. de Kleine; Hubert P.J. van der Doef; Thomas C. Kwee; Robbert J. de Haas

doi:10.1055/a-1961-9100

Ultrasound International Open, Table of Contents

CC BY 4.0 · Ultrasound Int Open 2022; 08(02): E36-E42
DOI: 10.1055/a-1961-9100

Original Article

Doppler Ultrasound of Vascular Complications After Pediatric Liver Transplantation: Incidence, Time of Detection, and Positive Predictive Value

Martijn V. Verhagen

¹Department of Radiology, UMCG, Groningen, Netherlands

,

Ruben H.J. de Kleine

²Department of Surgery, Division of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands

,

Hubert P.J. van der Doef

³Department of Pediatric Gastroenterology, UMCG, Groningen, Netherlands

,

Thomas C. Kwee

¹Department of Radiology, UMCG, Groningen, Netherlands

,

Robbert J. de Haas

¹Department of Radiology, UMCG, Groningen, Netherlands

› Author Affiliations

Abstract

Purpose Doppler ultrasound (DUS) is widely used to detect vascular complications after pediatric liver transplantation (LT). This study aimed to assess the moment of first detection of vascular complications with DUS, and to determine the positive predictive value (PPV) of DUS.

Materials and Methods Patients aged 0–18 years who underwent LT between 2015 and 2019 were retrospectively included. 92 LTs in 83 patients were included (median age: 3.9 years, interquartile range: 0.7–10.5). Patients underwent perioperative (intra-operative and immediately postoperative) and daily DUS surveillance during the first postoperative week, and at 1, 3, and 12 months. Vascular complications were categorized for the hepatic artery, portal vein, and hepatic veins. DUS findings were compared to surgical or radiological findings during the 1-year follow-up.

Results 52 vascular complications were diagnosed by DUS in 35/92 LTs (38%). 15 out of 52 (28.8%) were diagnosed perioperatively, 29/52 (55.8%) were diagnosed on postoperative days 1–7, and 8/52 (15.4%) after day 7. The PPV for all vascular complications diagnosed with DUS was 92.3%. During the 1-year follow-up, 18/19 (94.7%) hepatic artery complications, 19/26 (73.1%) portal vein complications, and 7/7 (100%) hepatic vein complications were diagnosed perioperatively or during the first week.

Conclusion The majority of vascular complications during the first year after pediatric LT were diagnosed by DUS perioperatively or during the first week, with a high PPV. Our findings provide important information regarding when to expect different types of vascular complications on DUS, which might improve DUS post-LT surveillance protocols.

Key words

hepatic veins - areas - structures & systems - hepatic arteries - ultrasound-color doppler - methods & techniques - ultrasound-spectral doppler - transplantation - themes

Full Text

References

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Supplementary Material

Supplementary Material