Published online Jul 21, 2016. doi: 10.3748/wjg.v22.i27.6145
Peer-review started: March 29, 2016
First decision: May 12, 2016
Revised: May 18, 2016
Accepted: June 13, 2016
Article in press: June 13, 2016
Published online: July 21, 2016
Living-donor liver transplantation has provided a solution to the severe lack of cadaver grafts for the replacement of liver afflicted with end-stage cirrhosis, fulminant disease, or inborn errors of metabolism. Vascular complications remain the most serious complications and a common cause for graft failure after hepatic transplantation. Doppler ultrasound remains the primary radiological imaging modality for the diagnosis of such complications. This article presents a brief review of intra- and post-operative living donor liver transplantation anatomy and a synopsis of the role of ultrasonography and color Doppler in evaluating the graft vascular haemodynamics both during surgery and post-operatively in accurately defining the early vascular complications. Intra-operative ultrasonography of the liver graft provides the surgeon with useful real-time diagnostic and staging information that may result in an alteration in the planned surgical approach and corrections of surgical complications during the procedure of vascular anastomoses. The relevant intra-operative anatomy and the spectrum of normal and abnormal findings are described. Ultrasonography and color Doppler also provides the clinicians and surgeons early post-operative potential developmental complications that may occur during hospital stay. Early detection and thus early problem solving can make the difference between graft survival and failure.
Core tip: In this article we focus on the role of intra- and post-operative Doppler ultrasonography in the early detection of potential vascular complications in living-donor liver transplantation, in addition to monitoring the surgical and interventional vascular therapeutic procedures.