Title:Doppler Ultrasound in the Diagnosis of Portal Vein Stenosis in Adult Living Donor Liver Transplant with Left Lobe Liver Grafts
Volume: 13
Author(s): Hsien-Wen Hsu, Tung-Liang Huang, Tai-Yi Chen, Leo Leung-Chit Tsang, Hsin-You Ou, Chun-Yen Yu, Yu-Fan Cheng*, Allan M. Concejero and Chao-Long Chen
Affiliation:
- 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305,Taiwan
Keywords:
Doppler ultrasound, left liver graft, living donor liver transplantation, portal vein stenosis.
Abstract: Objectives: Our aim was to identify ultrasound criteria that may be used to detect portal
vein stenosis (PVS) in adult living donor liver transplantation (ALDLT) with left lobe grafts.
Methods: 171 recipients underwent primary left lobe graft aldlt and routine liver doppler ultrasound
(DUS) as protocol. Another 151 right lobe liver donors who underwent pre-transplant and 6-
month follow-up post-hepatectomy dus were chosen as a control group.
Results: 68.4% (117/171) of the portal vein (PV) anastomoses can be well-visualized and measured
by DUS but could not be visualized in 31.6% (54/171).
Discussion: The values of portal anastomotic mean time averaged velocity (TAV) and change in
anastomotic/pre-anastomotic portal velocity (Δ TAV) were 51.5 and 31.3 cm/s, respectively, for significant
stenosis in patients with visualized PV anastomoses. Whether the PV anastomosis can be
visualized or not by dus, the increased umbilical portal vein width indicating possible narrowing of
the PV anastomosis was >2 cm. Increased TAV and Δ TAV are useful features to diagnose PVS in
ALDLT.
Conclusion: Identifying dilatation of left portal vein umbilical portion helps detecting PVS when
the narrowed anastomosis cannot be visualized.
