Study On The Color Ultrasound Of Hepatic Artery Blood Flow Abnormality Syndrome After Liver Transplantation

Objective:The most serious complication after liver transplantation is vascular complications,of which hepatic arterial complications are the most dangerous,which is the most important factor leading to liver failure and the death of recipients.Therefore,early diagnosis of hepatic artery complications,and active treatment to improve the survival rate of the recipient.Ultrasound has the advantages of non-invasive,flexible and dynamic observation.It can be analyzed from the perspective of hemodynamics and provide an important basis for clinical diagnosis of postoperative complications after liver transplantation.Hepatic artery blood flow abnormality syndrome refers to a series of manifestations of hepatic arterial blood flow abnormalities,hepatic parenchyma,and bile duct changes due to various reasons(such as hepatic artery complications,ischemia-reperfusion injury of transplanted liver,rejection,hypovolemia,etc).Hepatic arterial blood flow abnormalities do not necessarily cause hepatic artery complications,but hepatic arterial complications can be guarded against.The purpose of the study was to observe the changes of hepatic arterial hemodynamics,hepatic parenchyma,and bile ducts after liver transplantation by color doppler ultrasound,and analyze the characteristics of hepatic artery blood flow abnormality syndrome,in order to investigate the relationship between hepatic artery blood flow abnormality syndrome and hepatic artery complications after liver transplantation.Methods:During January 2014 to February 2018,the retrospective analysis of 132 patients undergoing allogeneic orthotopic liver transplantation at the First People's Hospital of Kunming,after undergoing color doppler ultrasound.The indicators with hemodynamic hepatic artery were used to diagnose hepatic artery blood flow abnormality syndrome(The hepatic portal hepatic artery RI<0.5 or RI>0.8;Hepatic portal hepatic artery SAT>0.08s;Hepatic portal hepatic artery PSV>180cm/s or PSV<40cm/s or continuously reduced;HAAC<300cm/s2;Hepatic portal,left or right arterial blood flow signals disappeared and disrupted or formed the hepatic arterial lateral branch).Contrast-enhanced ultrasound or CT angiography or digital subtraction angiography or surgery was used as the gold standard for the diagnosis of hepatic artery complications.And calculate the sensitivity,specificity,missed diagnosis rate and misdiagnosis rate of hepatic artery blood flow abnormality syndrome in the diagnosis of hepatic artery complications.Results:Among 132 patients with liver transplantation,4 cases were diagnosed as hepatic artery complications by CEUS or CTA or DSA or surgery,including 4 cases of HAT,0 case of HAS,0 case of HAP,and 0 case of SASS.Among the 132 cases of liver transplantation,13 cases were consistent with hepatic artery blood flow abnormality syndrome,of which HAT 3 cases(3/13),0 case of HAS,0 case of HAP,0 case of SASS,10 cases of other abnormalities.The sensitivity of hepatic arterial blood flow syndrome in the diagnosis of hepatic artery complications was 75.0%(3/4)and the specificity was 92.2%(118/128),the missed diagnosis rate was 25%,and the misdiagnosis rate was 7.8%.Conclusion:Hepatic artery blood flow abnormality syndrome can be used as a monitoring index to predict hepatic artery complications early.Early diagnosis of hepatic arterial blood flow abnormal syndrome and master its characteristics,can helps clinically treat hepatic artery complications timely and improve the survival rate of transplant recipients.