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Hepatic artery thrombosis after liver transplantation: Radiologic evaluation

Segel, MC and Zajko, AB and Bowen, A and Bron, KM and Skolnick, ML and Penkrot, RJ and Starzl, TE (1986) Hepatic artery thrombosis after liver transplantation: Radiologic evaluation. American Journal of Roentgenology, 146 (1). 137 - 141. ISSN 0361-803X

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Abstract

Hepatic artery thrombosis after liver transplantation is a devastating event requiring emergency retransplantation in most patients. Early clinical signs are often nonspecific. Before duplex sonography (combined real-time and pulsed Doppler) capability was acquired in October 1984, 76% of all transplants in this institution referred for angiography with a clinical suspicion of hepatic artery thrombosis had patent arteries. In an effort to reduce the number of negative angiograms, CT, real-time sonography, and pulsed Doppler have been evaluated as screening examinations to determine which patients need angiography. Of 14 patients with focal inhomogeneity of the liver architecture detected by CT and/or real-time sonography, 12 (86%) had hepatic artery thrombosis, one had slow arterial flow with hepatic necrosis, and one had a biloma with a patent hepatic artery. In 29 patients undergoing duplex sonography of the hepatic artery, six (21%) had absence of a Doppler arterial pulse. All six had abnormal angiograms: Four had thrombosis, one had a significant stenosis, and one had slow flow with biopsy-proven ischemia. Of 23 patients with a Doppler pulse, two had hepatic artery thrombosis at surgery. However, real-time sonography demonstrated focal inhomogeneity in the liver in both cases. Our data demonstrate that pulsed Doppler of the hepatic artery combined with real-time sonography of the liver parenchyma currently is the optimal screening test for selecting patients who require hepatic angiography after liver transplantation. A diagnostic algorithm is provided.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Segel, MC
Zajko, AB
Bowen, A
Bron, KM
Skolnick, ML
Penkrot, RJ
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1986
Date Type: Publication
Journal or Publication Title: American Journal of Roentgenology
Volume: 146
Number: 1
Page Range: 137 - 141
DOI or Unique Handle: 10.2214/ajr.146.1.137
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0361-803X
Other ID: uls-drl:31735062116110, Starzl CV No. 648
Date Deposited: 08 Apr 2010 17:11
Last Modified: 09 Dec 2017 12:55
URI: http://d-scholarship.pitt.edu/id/eprint/4034

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