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• W2510174733 abstract "In Brief Background Doppler ultrasound (DUS) arterial abnormalities (DAA) after orthotopic liver transplantation (OLT) often represent a sign of hepatic artery (HA) complication (HAC). The standard management of DAA involves computed tomographic angiography (CTA) followed by invasive vascular intervention (IVI) or observation. We evaluated the contribution of systemic vasodilators (SVD) to the management of DAA after OLT. Methods Between 2005 and 2015, 91 of 514 OLT recipients developed DAA (defined by HA resistive index [HARI] <0.5) and received oral SVDs. Doppler ultrasound was performed 2 days later, and patients were assigned to 3 groups accordingly: the normalization group (HARI >0.5), improvement group (HARI increase of >0.1 but value <0.5), or nonresponse group. We analyzed the contribution of this strategy to predict clinically significant HAC, defined as thrombosis or HAC requiring IVI. Results A clinically significant HAC (4 thromboses, 35 HACs requiring IVI) was found in 2.9% (n = 1/34), 32.1% (n = 9/28), and 100% (n = 29/29) of patients in the normalization, improvement, and nonresponse groups, respectively (P < 0.001). On multivariate analysis, absence of HARI normalization after SVD and time to DAA longer than 30 days were associated with clinically significant HAC. Specificity and accuracy of DUS after SVD increased from 88.1% to 95.1% and from 88.9% to 95.1% (P < 0.001), without altering its sensitivity (97.7% vs 95.5%, P = 1.000). Conclusions The use of SVD improves the diagnostic performance of DUS for clinically significant HAC after OLT. It allows identifying patients at low risk for HAC, for whom CTA could be avoided, and helps choosing between observation and IVI in patients with inconclusive CTA. The authors studied the phenomenon of low-resistive index in the hepatic artery after liver transplantation. Evidence suggests that the response to vasodilators reliably identifies the subset of patients with mechanical arterial stenoses that require intervention." @default.
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• W2510174733 date "2016-12-01" @default.
• W2510174733 modified "2023-09-23" @default.
• W2510174733 title "Use of Systemic Vasodilators for the Management of Doppler Ultrasound Arterial Abnormalities After Orthotopic Liver Transplantation" @default.
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• W2510174733 doi "https://doi.org/10.1097/tp.0000000000001450" @default.
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