AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Horrow, M. M.
Right arrow Articles by Manzarbeitia, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Horrow, M. M.
Right arrow Articles by Manzarbeitia, C.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Hotlight (NEW!)
Right arrow
What's Hotlight?

Sonographic Diagnosis and Outcome of Hepatic Artery Thrombosis After Orthotopic Liver Transplantation in Adults

Mindy M. Horrow1, Beth M. Blumenthal1,2, David J. Reich3 and Cosme Manzarbeitia3

1 Department of Radiology, Albert Einstein Medical Center, 5501 Old York Rd., Philadelphia, PA 19141-3098.
2 Present address: Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104.
3 Department of Surgery, Division of Transplant Surgery, Albert Einstein Medical Center, Philadelphia, PA.


Figure 1
View larger version (12K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1 —Flowchart shows outcomes of adult liver transplant recipients who developed early (< 1 week after transplantation) hepatic artery thrombosis.

 

Figure 2
View larger version (89K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2A —52-year-old woman with hepatic artery thrombosis detected on routine sonography 6 hours after liver transplantation. Color and pulsed Doppler sonography at porta hepatis show lack of flow in hepatic artery.

 

Figure 3
View larger version (136K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2B —52-year-old woman with hepatic artery thrombosis detected on routine sonography 6 hours after liver transplantation. Angiogram obtained after celiac artery injection confirms hepatic artery thrombosis detected at sonography.

 

Figure 4
View larger version (93K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2C —52-year-old woman with hepatic artery thrombosis detected on routine sonography 6 hours after liver transplantation. Color and pulsed Doppler sonography show normal hepatic artery (HA) flow after emergency surgical thrombectomy had been performed.

 

Figure 5
View larger version (122K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2D —52-year-old woman with hepatic artery thrombosis detected on routine sonography 6 hours after liver transplantation. CT scan obtained 1 month after transplantation shows chronic infarction of left lobe of liver and normal right lobe. Patient eventually died of unrelated cause.

 

Figure 6
View larger version (20K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 3 —Flowchart shows outcomes of adult liver transplant recipients who developed late (> 1 week after transplantation) hepatic artery stenosis.

 

Figure 7
View larger version (98K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 4A —61-year-old woman with biliary dilatation requiring a stent 24 months after liver transplantation developed hepatic artery thrombosis; collateral arterial flow resulted in false-negative sonography. Duplex Doppler image at porta hepatis shows arterial flow with parvus-tardus pattern (delayed systolic upstroke and low normal resistive index of 0.55).

 

Figure 8
View larger version (138K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 4B —61-year-old woman with biliary dilatation requiring a stent 24 months after liver transplantation developed hepatic artery thrombosis; collateral arterial flow resulted in false-negative sonography. Celiac axis angiogram shows complete occlusion of hepatic artery with collateral flow to liver (arrows).

 

Figure 9
View larger version (166K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 4C —61-year-old woman with biliary dilatation requiring a stent 24 months after liver transplantation developed hepatic artery thrombosis; collateral arterial flow resulted in false-negative sonography. Superior mesenteric angiogram shows small collateral vessels to liver (arrow).

 

Figure 10
View larger version (18K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 5 —Flowchart shows outcomes of adult liver transplant recipients with irreversible hepatic artery thrombosis.

 

Figure 11
View larger version (118K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 6A —47-year-old man who underwent sonography because of elevated liver function test results 2.5 weeks after liver transplantation. Sonography showed hepatic artery thrombosis (true-positive finding); initial postoperative sonography was normal. Power Doppler sonography image at porta hepatis shows flow in portal vein and no flow in hepatic artery.

 

Figure 12
View larger version (147K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 6B —47-year-old man who underwent sonography because of elevated liver function test results 2.5 weeks after liver transplantation. Sonography showed hepatic artery thrombosis (true-positive finding); initial postoperative sonography was normal. CT angiogram confirmed complete occlusion of hepatic artery (HA) (arrow), which was also depicted on angiography (not shown).

 

Figure 13
View larger version (105K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 6C —47-year-old man who underwent sonography because of elevated liver function test results 2.5 weeks after liver transplantation. Sonography showed hepatic artery thrombosis (true-positive finding); initial postoperative sonography was normal. Subsequently, patient developed an infected biloma that required percutaneous drainage and placement of biliary stent. Color and pulsed Doppler sonograms obtained 9 months after treatment of biloma show multiple small arterial vessels at porta hepatis with normal arterial waveform and absent portal vein flow (arrows).

 

Figure 14
View larger version (174K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 6D —47-year-old man who underwent sonography because of elevated liver function test results 2.5 weeks after liver transplantation. Sonography showed hepatic artery thrombosis (true-positive finding); initial postoperative sonography was normal. Angiogram obtained after superior mesenteric artery injection shows exuberant hepatic collaterals. Thrombosis of main portal vein was confirmed on portal venous phase.

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American Roentgen Ray Society.