Application Of Ultrasound In Vascular Complications After Liver Transplantation In Children

PART ?HEMODYNAMIC CHANGES AFTER LIVING RELATEDLIVER TRANSPLANTATION IN CHILDRENObjective: To investigate the hemodynamic changes of hepatic artery and portal vein after living related donor liver transplantation in children.Methods: The clinical data of 41 patients with biliary atresia(BA)who underwent living related liver transplantation in our hospital from May2018 to December 2019 were collected,and the changes of PSV,RI and PVV before and on the first day after liver transplantation were compared.Paired t-test and repeated measurement ANOVA were used for statistical analysis.Results: On the first day after LT,PSV and RI of hepatic artery decreased and PVV increased significantly(P < 0.05).For PVS,there was no significant difference in PSV between 1 week and 1 day after transplantation(P > 0.05).There was significant difference between 2weeks,1 month and 1 day after LT(P < 0.05).There was significant difference between 2 weeks,1 month and 1 week after transplantation(P <0.05).There was no significant difference between 1 month and 2 weeks after transplantation(P > 0.05).For RI and PVV,the decrease was very slowly within 1 month after operation.There was no significant difference at different times.Conclusion: On the first day after LT,PSV and RI of hepatic artery decreased while the PVV increased.The PSV decreased gradually in the second week and the RI and PVV did not change significantly in the first month after LT.PART ?THE VALUE OF ULTRASOUND IN THE DIAGNOSIS OF VASCULAR COMPLICATIONS AFTER LIVER TRANSPLANTATION IN CHILDRENObjective: To explore the value of ultrasonography in the diagnosis of hepatic artery and portal vein complications after liver transplantation in children.Methods: The clinical data of 91 cases of liver transplantation in our hospital from February 2013 to December 2019 were analyzed retrospectively.The sensitivity and specificity of ultrasound in the diagnosis of common HA and PV complications were analyzed,and the incidence of HA and PV complications between LDLT and DDLT were compared.The results of operation,DSA,CTA and clinical outcomes were taken as the gold standard.Results:There were 34 vascular complications in 91 children,including 5 HATs,5 HASs,8 PVTs and 16 PVSs.The sensitivity,specificity,accuracy and false-positive rate of ultrasound diagnosis of HAT,HAS,PVT and PVS were 80%?97.67%?96.70%?2.33%,60%?98.83% ?96.70%?1.17%,100%?98.79%?98.90%?1.21%,68.75%?94.67%?90.11%?5.33% respectively.There was no significant difference in the incidence of vascular complications between DDLT and LDLT(P >0.05),and there was significant difference in the incidence of HAT between the two groups(0.128 vs 0,X2 = 7.054,P < 0.05).Conclusion: Ultrasound has higher specificity but lower sensitivity in the diagnosis of hepatic artery and portal vein complications after liver transplantation in children,especially in vascular stenosis.HATs mainly occured in DDLT,and the others had no significant difference between LDLT and DDLT.