Changes in portal hemodynamics and acute rejection in the first 2 weeks after orthotopic liver transplantation. A prospective Doppler ultrasound study.

RATIONALE AND OBJECTIVES: To analyze changes in Doppler ultrasound variables of the portal vein in relation to liver biopsy findings, the authors performed a prospective study of 316 Doppler ultrasound examinations in the first 2 weeks after orthotopic liver transplantation on 23 patients. METHODS: Recordings were obtained daily from the portal vein (diameter, maximum velocity, and flow). Correlations were explored between the Doppler ultrasound findings and histologic data. The chi-square test was used to analyze differences in Doppler ultrasound variables in patients with and without acute rejection. RESULTS: In our series of 23 patients, acute rejection was diagnosed by liver biopsy in nine of them (39%). Changes in portal vein diameter, maximum velocity, and flow did not correlate consistently with liver biopsy findings, due to a multifactorial origin. Changes in portal hemodynamics were observed in patients with hepatic artery thrombosis, portal vein stenosis, acute rejection, and sepsis. CONCLUSIONS: Although routine screening using Doppler ultrasound proved to be useful for the determination of rapid changes in portal hemodynamics within a short time, serial Doppler ultrasound examinations were not helpful in predicting acute rejection.

Scintigraphic detection of urinary leakage after kidney transplantation.

Urinary leakage after kidney transplantation is a serious complication. In a retrospective study we analyzed 8 relevant cases of 14 patients with urinary leakage. In these eight patients kidney scintigraphy indicated the presence of urinary extravasation. Compared with other imaging modalities such as IV urography, cystography and ultrasound, scintigraphy seems to be an easy and safe method to detect urinary leakage. Moreover scintigraphic examination may suggest leakage, while this may not be clinically evident or suspected.