Implications of Doppler Alterations on Outcomes After Liver Transplantation. Our Experience in the Last Seven Years. (July 2018)

• Record Type: Journal Article
• Authors: Cobo, Cristina; Justo, Iago; Manrique, Alejandro; Caso, Óscar; Calvo, Jorge; Cambra, Félix; Marcacuzco, Alejandro; Jiménez, Carlos
• Is Part Of: Transplantation. Volume 102(2018)Supplement 7S-1
• Publication Date: 2018-07
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/01.tp.0000543944.66342.7e
• Languages: English
• ISSNs: 0041-1337

Abstract

Backgrounds: Arterial thrombosis (HAT) is the most frequent vascular complication after liver transplantation. It is the most feared of them, with an incidence of 0-12% in early HAT, and 2-25% in late HAT in adults. It is also the second most frequent cause of graft failure. Due to the important morbidity associated and the challenge that often involves diagnosis, the post-transplant Doppler studies are protocolized in the immediate follow-up of these patients. We aim to analyze the outcome of those patients with arterial doppler flow alterations without reaching criteria of thrombosis. Objectives: We aim to analyze the clinical significance of Doppler alterations in patients without HAT criteria. Material and Methods: Between January 2009 and December 2015, 456 liver transplants were performed. 28 were pediatric patients. All of them underwent a Doppler in the first 24-48. These alterations were mostly described as Resistance Index (RI) > 0.8, although 2 cases with RI <0.5 have also been considered. Analysis were performed with 4 groups of adult patients: those with normal Doppler (A), altered Doppler without posterior complications (B), those who progressed to HAT (C) and those who only presented HAT (D). Figure. No caption available. Results: Of the 456 transplanted livers, 28 were pediatric patients. Of the 428 adults, we found 305 patients (71.27%) in group A, 95 (22.20%) in group B, 5 (0.12%) in group C and 23 (5.38%) in group D. In pediatric THO we found 12 patients (48.86%) in group A, 8 (28.57%) in B, 3 (10.71%) in C and 5 (7.86%) in D. No differences have been found between groups with regards to MELD Score, DCD donors nor hemoderivates transfusions. Hepatocarcinoma (HC) was found with the following distribution: group A (43.47%), group B (33.87%) and group D (21.42%). None of patients in group C had HC (p<0, 05). Figure. No caption available. Figure. No caption available. Figure. No caption available. Conclusion: Doppler ultrasonography is an excellent tool for evaluating vascular complications in transplanted patients, but altered values in RI do not always lead to complications. In our series, there were 22.20% of adult patients and 28.57% of pediatric patients with Doppler abnormalities without clinical complications. Therefore, the clinical implications of an altered RI still need to be established.