Abstract :
Living donor liver transplantation (LDLT) has been the last resort to treat endstage liver disease with improved success rates, provided the recent advances among the surgical technology, radiological appliances and new immune-suppressants. Vascular complications among liver transplant recipients are noted as a major threat to recipients’ survival. Slender anastomotic vessels make recipients more prone to complications through the reconstruction process. Routine postoperative Doppler ultrasound surveillance is believed to play a major role in early diagnosis of complications through intra-operative and early post-operative assessment allowing timed accurate management and increasing chances of survival for the liver graft and recipients. This prospective work is done on 45 cases with end-stage liver disease for whom adult LDLT is performed. Forty-five liver transplant cases were included in our study. Routine Doppler ultrasound surveillance diagnosed twelve patients to have vascular complications. Further evaluation of these cases by triphasic CT study or by surgical exploration confirmed eleven out of the twelve cases to suffer true vascular complications and only one false positive case was found free from complication. Thirty-three cases were marked by Doppler ultrasound as free from complications and one false negative case was found. Routine DUS surveillance of liver graft recipients have 91.67% Sensitivity and 96.97%Specificity to detect vascular complications. Intra-operative assessment and early postoperative surveillance of adult living donor liver transplant recipients using Doppler ultrasound can detect or exclude vascular complications with high accuracy.
