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Collateral Transformation of the Hepatic Artery After Liver Transplantation

Philip B. Dydynski1, Edward I. Bluth1, Wilson Altmeyer1, Daniel A. Devun1 and James M. Milburn1

1 All authors: Department of Radiology, Ochsner Medical Center, 1514 Jefferson Hwy., New Orleans, LA 70121.


Figure 1
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  		Fig. 1A —44-year-old woman who underwent orthotopic liver transplantation as well as Roux-en-Y hepaticojejunostomy. Sonogram acquired at 1-month follow-up shows hepatofugal flow in posterior branch of right hepatic artery (RHA). RPV = right portal vein, REV = reverse, POS = posterior.

 

Figure 2
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  		Fig. 1B —44-year-old woman who underwent orthotopic liver transplantation as well as Roux-en-Y hepaticojejunostomy. Sonogram acquired at 3-month follow-up shows collateral arteries (arrows) in porta hepatis region.

 

Figure 3
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  		Fig. 1C —44-year-old woman who underwent orthotopic liver transplantation as well as Roux-en-Y hepaticojejunostomy. Angiogram acquired 1 day after sonogram in B shows collateral transformation of hepatic artery, confirming occlusion of main hepatic artery.

 

Figure 4
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  		Fig. 2A —55-year-old man who underwent orthotopic liver transplantation for cirrhosis secondary to chronic hepatitis C. Sonogram acquired 2 months after transplantation shows small collateral vessels in porta hepatis region. No Doppler flow of extrahepatic main hepatic artery was identified, suggestive for hepatic artery thrombosis.

 

Figure 5
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  		Fig. 2B —55-year-old man who underwent orthotopic liver transplantation for cirrhosis secondary to chronic hepatitis C. Angiogram acquired after sonogram in A shows multiple collateral vessels reconstituting right hepatic artery branches.

 

Figure 6
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  		Fig. 2C —55-year-old man who underwent orthotopic liver transplantation for cirrhosis secondary to chronic hepatitis C. Sonogram acquired 1 month after angiogram in B shows similar findings. Reversal of flow (hepatofugal) in right hepatic artery (RHA) was identified (arrow) and showed triphasic arterial waveform thought to be secondary to retrograde flow from supplying collateral arteries—similar to patient 1. RPV = right portal vein, REV = reverse, POS = posterior.

 

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