REVERSED OR ABSENT HEPATIC ARTERIAL DIASTOLIC FLOW IN LIVER-TRANSPLANTS SHOWN BY DUPLEX SONOGRAPHY - A POOR PREDICTOR OF SUBSEQUENT HEPATIC-ARTERY THROMBOSIS

OBJECTIVE. We studied the value of absent or reversed diastolic flow in the hepatic artery, shown by duplex sonography of recently transplanted livers, in predicting subsequent hepatic artery thrombosis, MATERIALS AND METHODS. We retrospectively reviewed the records of liver transplantations performed in adults during a 3-year period at our institution. Duplex Doppler studies were done within 24 hr after transplantation and subsequently reviewed. The clinical course of all patients with absent or reversed diastolic flow in the hepatic artery immediately after transplantation was evaluated. RESULTS. Of the 160 liver transplants included in this study, 30 had aberrant diastolic flow in the hepatic artery immediately after transplantation. Twenty had reversed flow, and 10 showed no flow in diastole. In this group of 30 transplants, complications developed in six; two were vascular in origin. One of these complications was thrombosis of the hepatic artery 12 months after transplantation. This 3% thrombosis rate is similar to the 4.6% thrombosis rate of the 130 patients who had antegrade diastolic flow in the hepatic artery immediately after transplantation. CONCLUSION. Reversed or absent diastolic flow in the hepatic artery of a recently transplanted liver has no correlation with subsequent hepatic artery thrombosis.