Significant decline in portal vein flow velocity observed at 1 month after liver transplantation
Liver transplant patients monitored by Doppler ultrasound showed a significant decrease in portal vein flow velocity 1 month after transplantation that continued to decline during the next 3 years, according to recent study data.
Researchers conducted a retrospective study of 144 liver transplant patients (mean age, 48.9 years; 78% men) from Zhongshan Hospital, Fudan University, Shanghai, between October 2005 and March 2009. Each patient had a postoperative ultrasound examination once a day during the first 7 days, once a week for the next 2 to 4 weeks, then once every 3 months for up to 1 year. After that, the exam was repeated once every 3 to 6 months for up to 4 years. Cirrhosis with carcinoma precipitated 127 transplants; all other patients had cirrhosis.
Portal vein flow velocity (PVFV) decreased from a mean of 72.1 ± 30.3 cm/s at 1 day after transplantation to 44.2 ± 20.1 cm/s at 1 month (P<.05). At 4 years, mean PVFV was 25.4 ± 8.1 cm/s (P<.05). Mean hepatic artery flow velocity fell from 61.4 ± 33.2 cm/s at 1 day post-transplant to 48.3 ± 20.4 cm/s at 3 years (P<.05), then rose to 50.5 ± 14.3 cm/s at 4 years (P<.05).
Eighty-one patients (56.3%) displayed high hepatic artery resistance index (HARI; >.0.8), and HARI was considered low (<0.5) in 19 (13.2%) patients at least once during follow-up.
“This study documented the range of the changes observed in the hemodynamic data measured in the transplanted liver without complications,” the researchers wrote. “We recommend that the appropriate follow-up time-points after liver transplantation with ultrasonography are: once a day during the first 7 days, once a week for the following 2 to 4 weeks, then once every 3 months for up to a year, and then once every 6 months.
“Abnormal Doppler results should be interpreted with caution because they may not be clinically significant and improve spontaneously.”
Disclosure: The researchers report no relevant financial disclosures.