Doppler Sonography of Patients With and Without Acute Cellular Rejection After Right-Lobe Living Donor Liver Transplantation

Objectives-To compare percent interval changes in the portal blood flow velocity (%PBV) and venous pulsatility index (%VPI), as determined by Doppler sonography, in patients with and without acute cellular rejection after right-lobe living donor liver transplantation. Methods-Forty-seven patients with biopsy-proven acute cellular rejection underwent Doppler sonography. The control group consisted of 47 age- and sex-matched patients without acute cellular rejection. Doppler spectrograms of the portal vein and right hepatic vein were used to calculate mean peak PBVs and VPIs for the first 3 days after right-lobe living donor liver transplantation, defined as PBVBaseline and VPIBaseline. The PBV and VPI closest in time to biopsy in the patient group or at a matched time in the control group were determined as PBVEvent and VPIEvent, and %PBV and %VPI values were calculated. Results-The mean PBVBaseline values +/- SD in the rejection and control groups were 46.0 +/- 21.8 and 44.4 +/- 20.5 cm/s, respectively; the PBVEvent values were 32.2 +/- 14.5 and 34.4 +/- 17.1 cm/s; and the %PBV values were 19.4% +/- 39.9% and 2.2% +/- 75.4% (P = .73; P = .38; P = .17, respectively). The PBVBaseline values were 0.92 +/- 0.34 and 0.93 +/- 0.38; the VPIEvent values were 0.46 +/- 0.33 and 0.84 +/- 0.44 (P = .94; P < .001); and the %VPI values were 45.5% +/- 40.1% and 5.6% +/- 47.3%, with a greater than 50% VPI observed more frequently in the rejection than in the control group (61.7% versus 12.8%; P < .001). Conclusions-The VPIEvent was significantly lower and a greater than 50% VPI was significantly more frequent in patients with than without acute cellular rejection after right-lobe living donor liver transplantation.