THE ROLE OF ULTRASOUND IN IDENTIFYING VASCULAR COMPLICATIONS IN LIVER TRANSPLANT RECIPIENTS
Introduction. Liver transplantation is a complex procedure that requires careful monitoring of possible complications. One of the key methods for diagnosing postoperative vascular disorders is ultrasound (USG), which allows timely detection of complications and measures to eliminate them. Ultrasound is a non-invasive, accessible and highly informative method, which makes it an important tool in post-transplantation management of patients.
Aim of the study. To evaluate the role of ultrasound in the diagnosis of vascular complications in liver transplant recipients.
Materials and methods. Ninety-three patients who underwent liver transplantation from June 2013 to February 2024 were included in the study. Comprehensive ultrasound including B-mode and Doppler study was used to evaluate vascular complications. Main parameters: patency and vascular anatomy, blood flow in the hepatic artery, portal and hepatic veins. The results were analyzed using EpiInfo program.
Results. In 42 patients (45.16%), vascular complications were identified, including hepatic artery thrombosis (11 cases, 26.19%), portal vein stenosis (1 case, 2.38%), and portal vein thrombosis (4 cases, 9.52%). Ultrasound demonstrated high accuracy and sensitivity in diagnosing vascular thrombosis and stenosis (100% for hepatic artery and portal vein thrombosis).
Conclusions. Ultrasound is an effective method for diagnosing vascular complications after liver transplantation. High sensitivity and accuracy make it an indispensable tool in early diagnosis and monitoring of patients, which contributes to the successful outcome of transplantation.
Damesh R. Orazbaeva1, https://orcid.org/0000-0002-9280-9944
Gulnur Isa1, https://orcid.org/0009-0000-7128-3501
Ilyas K. Sagyndykov1, https://orcid.org/0009-0006-7877-4315
Ermek A. Akhmetov1, https://orcid.org/0000-0002-6042-4935
Almira M. Manatova1, https://orcid.org/0009-0007-6460-5606
Dinara S. Zharlyganova1, https://orcid.org/0000-0001-6383-4035
Готе С.В., Восканов М.А., Монахов А.Р., Сыомаш К.О. Роль эндоваскулярных и эндобилиарных методов в лечении осложнений после трансплантации печени. Вестник трансплантологии и искусственных органов. 2020. Т.22, №4. С.140-148. DOI:https://doi.org/10.15825/1995-1191-2020-4-140-148.
2. Коробка В.Л., Кострыкин М.Ю., Малеванный М.В., Котов О.В., Коробка Р.В., Пак Е.С., Хоронко Ю.В., Сапронова Н.Г., Суханов И.А., Хоронко Р.Ю. Лечение сосудистых осложнений после ортотопической трансплантации печени. Опыт регионального центра. Вестник трансплантологии и искусственных органов. 2023. Т.25, №4. С.22-31. DOI:https://doi.org/10.15825/1995-1191-2023-4-22-31.
3. Трансплантологический центр [Електронный ресурс]. https://transplant.kz/ru/statistika. (Дата обращения 23.09.2024)
4. Ahmed Z. et al. Doppler ultrasound in diagnosing vascular complications post liver transplantation. Journal of Clinical Imaging. 2020. Vol. 74, No. 4. P. 211-215.
5. Allen U.D., Preiksaitis J.K. Post-Transplant Vascular Complications Detected via Ultrasound in Solid Organ Transplantation. Clinical Transplantation. 2019. Т. 33, № 2. С. e13652.
6. Bakker N.A., van Imhoff G.W., Verschuuren E.A. Doppler Ultrasound Performance in Detecting Early Vascular Anomalies Post-Liver Transplantation. Transplantation International. 2020. Т. 33, № 1. С. 207-218.
7. Camacho J.C., Moreno C.C., Harri P.A., et al. Postoperative Doppler Ultrasound to Detect Early Vascular Complications in Liver Transplantation. Radiology Research and Practice. 2020. Т. 10, № 3. С. 202-210.
8. Camacho J.C., Coursey-Moreno C., Telleria J.C., et al. Utility of Doppler Ultrasonography for Portal Vein Thrombosis Detection in Liver Transplant Recipients. Radiographics. 2023. Т. 35, № 1. С. 87-104.
9. Duffy J.P., Hong J.C., Farmer D.G., Ghabrial R.M., Yersiz H., Hiatt J.R., Busuttil R.W. Vascular complications of orthotopic liver transplantation: experience in more than 4200 patients. J. Am. Coll. Surg. 2009. Vol. 208. рp. 896–905.
10. Friedewald S.M., Molmenti E.P., DeJong M.R. Vascular and Nonvascular Complications of Liver Transplants: Role of Sonographic Evaluation. Ultrasound Quarterly. 2021. Т. 19, № 2. С. 71-85.
11. Frontiers Publishing Partnerships. Routine Doppler Ultrasound to Detect Early Post-Liver Transplant Vascular Complications. Frontiers in Transplantation. 2023. Т.1, № 2. С. 22-30.
12. Glockner J.F., Forauer A.R. Doppler Ultrasonography for Detection of Hepatic Artery Thrombosis Post-Liver Transplantation. American Journal of Roentgenology. 2022. Т. 199, № 5. С. 1055-1065.
13. Harrison J., Doria C. Hepatic Artery Pseudoaneurysm Post-Liver Transplant: Diagnostic Approaches via Doppler Ultrasound. Annals of Transplantation. 2021. Т. 26. С. 437-445.
14. Khussain H., Rafique M.S., Kundi S., Malik T., Zia Ud din A., Saeed A. Role of Doppler ultrasound in detecting vascular complications in recipients of living donor liver transplant. Journal of the Pakistan Medical Association. 2023. Vol. 73, No. 05. P. 1007–1012. DOI: https://doi.org/10.47391/JPMA.6952.
15. Kryzhanovskaya E.Yu., Kamalov Yu.R., Sandrikov V.A. Dynamic Comprehensive Ultrasound Examination in the Assessment of the State of the Right Lobe Liver Graft from a Living Related Donor. Ultrasonic and Functional Diagnostics. 2015. No. 3. pp. 26.
16. Mohan S., Bhaskaran A., Kathpalia R. Role of Doppler Ultrasound in Evaluation of Vascular Complications Post Liver Transplant. Abdominal Radiology. 2021. Vol. 46, No. 2. P. 754-762. DOI: 10.1007/s00261-020-02703-w.
17. Park Y.S., Kim K.W., Lee S.J. Hepatic Arterial Stenosis Assessed with Doppler US After Liver Transplantation: False-Positive Diagnoses and the Value of Peak Systolic Velocity Cutoffs. Radiology. 2019. Т. 290, № 3. С. 884-891.
18. Said A., Safdar N., Lucey M.R. Detection of Hepatic Vein Outflow Obstruction Post-Transplant Using Doppler Ultrasound. American Journal of Transplantation. 2022. Т. 22, № 2. С. 574-582.
19. Sanyal R., Zarzour J.G., Ganeshan D.M., Bhargava P., Lall C.G., Little M.D. Postoperative Doppler assessment of liver transplant. Indian J Radiol Imaging. 2014. Vol. 24. Pp. 360–366.
20. Starzl T.E., Marchioro T.L., Von Kaulla K.N., Hermann G., Brittain R.S., Waddell W.R. Homotransplantation of the human liver. Surg Gynecol Obstet. 1963. Vol. 117. Pp. 659–676.
References:
1. Gote S.V., Voskanov M.A., Monakhov A.R., Syomash K.O. Rol' endovaskulyarnykh i endobiliarnykh metodov v lechenii oslozhnenii posle transplantatsii pecheni [The role of endovascular and endobiliary methods in the treatment of complications after liver transplantation]. Vestnik transplantologii i iskusstvennykh organov [Bulletin of Transplantology and Artificial Organs]. 2020. Vol. 22, No. 4. Pp. 140-148. DOI: https://doi.org/10.15825/1995-1191-2020-4-140-148.
2. Korobka V.L., Kostrykin M.Yu., Malevannyi M.V., Kotov O.V., Korobka R.V., Pak E.S., Khoronko Yu.V., Sapronova N.G., Sukhanov I.A., Khoronko R.Yu. Lechenie sosudistykh oslozhnenii posle ortotopicheskoi transplantatsii pecheni [Treatment of vascular complications after orthotopic liver transplantation. Experience of the regional center]. Opyt regional'nogo tsentra. Vestnik transplantologii i iskusstvennykh organov [Bulletin of transplantology and artificial organs]. 2023. Vol. 25, No. 4. Pp. 22-31. DOI:https://doi.org/10.15825/1995-1191-2023-4-22-31.
3. Transplantologicheskiy tsentr [Transplantology center] Elektronnyi resurs [Electronic resource]. https://transplant.kz/ru/statistika. (Accessed 23.09.2024)
Number of Views: 200
Bibliography link
Orazbaeva D.R., Isa G., Sagyndykov I.K., Akhmetov E.A., Manatova A.M., Zharlyganova D.S. The role of ultrasound in identifying vascular complications in liver transplant recipients // Nauka i Zdravookhranenie [Science & Healthcare]. 2024. Vol.26 (5), pp. 79-84. doi 10.34689/SH.2024.26.5.010Related publications:
COMMUNITY-ACQUIRED PNEUMONIA IN PREGNANT. CLINICAL CASE.
THE RELATIONSHIP BETWEEN BODY MASS INDEX AND BONE MINERAL DENSITY IN THE MIDDLE-AGED AND ELDERLY POPULATION
CURRENT STATE OF DERMATOPHYTE RESISTANCE TO ANTIMYCOTIC AGENTS
CLINICAL, MORPHOLOGICAL AND MORPHOMETRIC ASSESSMENT OF GRANULOMATOUS INFLAMMATION IN SARCOIDOSIS AND PULMONARY TUBERCULOSIS
DRUG-INDUCED LIVER INJURY IN HIV-INFECTED PATIENTS WITH ACTIVE TUBERCULOSIS: COMPARATIVE LABORATORY CHARACTERIZATION