Liver transplantation has been established as a first-line therapy for a number of indications. Conventional ultrasound and contrast-enhanced ultrasound (CEUS) are methods of choice during the postoperative period as a safe and fast tool to detect potential complications and to enable early intervention if necessary. CEUS increases diagnostic quality and is an appropriate procedure for the examination of vessels and possibly bile ducts. This article presents the state of the art of ultrasound application during the early period after liver transplantation. It addresses common vascular complications and describes the identification of postoperative abnormal findings using ultrasound and CEUS.
LeeHLimCWYooSH. The effect of Doppler ultrasound on early vascular interventions and clinical outcomes after liver transplantation. World J Surg2014; 38: 3202–3209.
2.
AkunEYaprakOKilliR. Vascular complications in hepatic transplantation: single-center experience in 14 years. Transplant Proc2012; 44: 1368–1372.
3.
LeutloffUCScharfJRichterGM. Der Einsatz des Ultraschallkontrastmittels Levovist® in der Nachsorge von Lebertransplantationen. Radiologe1998; 38: 399–404.
4.
AzzamAZTanakaK. Management of vascular complications after living donor liver transplantation. Hepatogastroenteroloy2012; 59: 182–186.
5.
KokTSlooffMJThijnCJ. Routine Doppler ultrasound for the detection of clinically unsuspected vascular complications in the early postoperative phase after orthotopic liver transplantation. Transpl Int1998; 11: 272–276.
WeissSSchmidtSCUlrichF. Biliary reconstruction using a side-to-side choledochocholedochostomy with or without T-tube in deceased donor liver transplantation: a prospective randomized trial. Ann Surg2009; 250: 766–771.
8.
GiromettiRComoGBazzocchiM. Post-operative imaging in liver transplantation: State-of-the-art and future perspectives. World J Gastroenterol2014; 20: 6180–6200.
RennertJDorniaCGeorgievaM. Identification of early complications following liver transplantation using contrast enhanced ultrasound (CEUS). First results. J Gastrointestin Liver Dis2012; 21: 407–412.
11.
JeongWKLimHKLeeHK. Principles and clinical application of ultrasound elastography for diffuse liver disease. Ultrasonography2014; 33: 149–160.
12.
ChopraSSEiseleRGuckelbergerO. Impact of duplex ultrasound on diagnosis and therapy of Lienalis Steal syndrome following liver transplantation. Ultraschall Med2012; 33: E366–E368.
13.
BekkerJPloemSde JongKP. Early hepatic artery thrombosis after liver transplantation: a systemic review of the incidence, outcome and risk factors. Am J Transplant2009; 9: 746–757.
14.
SilvaMJambulingamPSGunsonBK. Hepatic artery thrombosis following orthotopic liver transplantation: a 10-year experience from a single center in the United Kingdom. Liver Transpl2006; 12: 146–151.
15.
García-CriadoAGilabertRBianchiL. Impact of contrast-enhanced ultrasound in the study of hepatic artery hypoperfusion shortly after liver transplantation: contribution to the diagnosis of artery steal syndrome. Eur Radiol2014; 25: 196–202.
16.
UllerWKnoppkeBSchreyerAG. Interventional radiological treatment of perihepatic vascular stenosis or occlusion in pediatric patients after liver transplantation. Cardiovasc Intervent Radiol2013; 36: 1562–1567.
17.
NoltenASproatIA. Hepatic artery thrombosis after liver transplantation: temporal accuracy of diagnosis with duplex US and the syndrome of impending thrombosis. Radiology1996; 198: 553–559.
18.
SidhuPSBaxterGM. Ultrasound of abdominal transplantation, 1st ed. Stuttgart: Georg Thieme Verlag, 2002.
19.
CrossinJDMuradaliDWilsonSR. US of liver transplants: normal and abnormal. Radiographics2003; 23: 1093–1114.
20.
TzakisAGGordonRDShawBWJr. Clinical presentation of hepatic artery thrombosis after liver transplantation in the cyclosporine era. Transplantation1985; 40: 667–671.
21.
FlintEWSumkinJHZajkoAB. Duplex sonography of hepatic artery thrombosis after liver transplantation. Am J Roentgenol1988; 15: 481–483.
22.
HomBKShresthaRPalmerSL. Prospective evaluation of vascular complications after liver transplantation: comparison of conventional and microbubble contrast-enhanced US. Radiology2006; 241: 267–274.
23.
PorrettPMHsuJShakedA. Late surgical complications following liver transplantation. Liver Transpl2009; 15: S12–S18.
24.
DeneckeTLangrehrJLopez HänninenE. Transhepatic computed tomography-guided management of bleeding hepatic arterial pseudoaneurysm inaccessible for angiography in a liver transplant recipient. Transpl Int2007; 20: 728–730.
25.
GlocknerJFForauerAR. Vascular or ischemic complications after liver transplantation. Am J Roentgenol1999; 173: 1055–1059.
26.
LerutJTzakisAGBronK. Complications of venous reconstruction in human orthotopic liver transplantation. Ann Surg1987; 205: 404–414.
MullanCPSiewertBKaneRA. Can Doppler sonography discern between hemodynamically significant and insignificant portal vein stenosis after adult liver transplantation?Am J Roentgenol2010; 195: 1438–1443.
32.
WojcickiMPostMPakosz-GolanowskaM. Vascular complications following adult piggyback liver transplantation with end-to-side cavo-cavostomy: a single-center experience. Transplant Proc2009; 41: 3131–3134.
33.
Hejazi KenariSKZimmermannAEslamiM. Current state of art management for vascular complications after liver transplantation. Middle East J Dig Dis2014; 6: 121–130.
34.
KoEYKimTKKimPN. Hepatic vein stenosis after living donor liver transplantation: evaluation with Doppler US. Radiology2003; 229: 806–810.
35.
SinghAKNachiappanACVermaHA. Postoperative imaging in liver transplantation. What radiologists should know. Radiographics2010; 30: 339–351.
36.
UsochukwuLNBluthEISmethermanDH. Early postoperative hepatic sonography as a predictor of vascular and biliary complications in adult orthotopic liver transplant patients. Am J Roentgenol2005; 185: 1558–1570.
37.
De CarlisLSansaloneCVRondinaraGF. Splenic artery steal syndrome after orthotopic liver transplantation: diagnosis and treatment. Transplant Proc1993; 25: 2594–2596.
38.
GeisslerILameschPWitzigmannH. Splenohepatic arterial steal syndrome in liver transplantation: clinical features and management. Transpl Int2002; 3: 139–141.
39.
JakabFRathZSchmalF. The interaction between hepatic arterial and portal venous blood flows; simultaneous measurement by transit time ultrasonic volume flowmetry. Hepatogastroenterology1995; 42: 18–21.
40.
EzzatWRLauttWW. Hepatic arterial pressure-flow autoregulation is adenosine mediated. Am J Physiol1987; 2: H836–H845.
41.
MoglMTNüsslerNCPresserSJ. Evolving experience with prevention and treatment of splenic artery syndrome after orthotopic liver transplantation. Transpl Int2010; 23: 831–841.
42.
GrieserCDeneckeTSteffenI. Multidetector row computed tomography for preoperative assessment of hepatic vasculature and prediction of splenic artery steal syndrome in patients with liver cirrhosis before transplantation. Eur Radiol2010; 20: 108–117.
43.
BadeaRChioreanLMitreC. Spontaneous retroperitoneal and subcapsular liver hematoma. The diagnostic contribution of CT, US and CEUS. Case report. Med Ultrason2013; 15: 157–160.
44.
SongHPYuMZhangM. Diagnosis of active hemorrhage from the liver with contrast-enhanced ultrasonography after percutaneous transhepatic angioplasty and stent placement for Budd-Chiari syndrome. J Ultrasound Med2009; 28: 955–958.
45.
LetourneauJGCastañeda-ZuñigaWR. The role of radiology in the diagnosis and treatment of biliary complications after liver transplantation. Cardiovasc Intervent Radiol1990; 13: 278–282.
46.
CollettiniFKroenckeTJHeidenhainC. Ischemic-type biliary lesions after ortothopic liver transplantation: diagnosis with magnetic resonance cholangiography. Transplant Proc2011; 43: 2660–2663.
47.
Alegre CastellanosAMolina GranadosJFEscribano FernandezJ. Early phase detection of bile leak after hepatobiliary surgery: value of Gd-EOB.DTPA-enhanced MR cholangiography. Abdom Imaging2012; 37: 795–802.
48.
ChopraSSEiseleRStelterL. Contrast enhanced ultrasound cholangiography via T-tube following liver transplantation. Ann Transplant2012; 17: 108–112.
49.
Ayres R, Adams D. Acute rejection of human liver allografts. In: Neuberger J, Adams D (eds). Immunology of liver transplantation. British Library Cataloguing in Publication Data. 1993;197–211.
50.
MarderDMDeMarinoGBSumkinJH. Liver transplant rejection: value of the resistive index in Doppler US of hepatic arteries. Radiology1989; 173: 127–129.
