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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2016; 22(4): 1617-1626
Published online Jan 28, 2016. doi: 10.3748/wjg.v22.i4.1617
Vascular complications after adult living donor liver transplantation: Evaluation with ultrasonography
Lin Ma, Qiang Lu, Yan Luo
Lin Ma, Qiang Lu, Yan Luo, Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Ma L performed the literature review and wrote the paper; Lu Q and Luo Y provided expertise and critical revision of the manuscript.
Supported by The Department of Science and Technology of Sichuan Province, China, No. 2013JY0147; and the National Natural Science Foundation of China, No 81371556.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Yan Luo, Department of Ultrasound, West China Hospital of Sichuan University, 37 Guoxue Lane, Chengdu 610041, Sichuan Province, China. luoyand@hotmail.com
Telephone: +86-28-85423192 Fax: +86-28-85423192
Received: April 28, 2015
Peer-review started: May 6, 2015
First decision: August 26, 2015
Revised: September 12, 2015
Accepted: November 13, 2015
Article in press: November 13, 2015
Published online: January 28, 2016
Processing time: 266 Days and 18.9 Hours
Abstract

Living donor liver transplantation (LDLT) has been widely used to treat end-stage liver disease with improvement in surgical technology and the application of new immunosuppressants. Vascular complications after liver transplantation remain a major threat to the survival of recipients. LDLT recipients are more likely to develop vascular complications because of their complex vascular reconstruction and the slender vessels. Early diagnosis and treatment are critical for the survival of graft and recipients. As a non-invasive, cost-effective and non-radioactive method with bedside availability, conventional gray-scale and Doppler ultrasonography play important roles in identifying vascular complications in the early postoperative period and during the follow-up. Recently, with the detailed vascular tracing and perfusion visualization, contrast-enhanced ultrasound (CEUS) has significantly improved the diagnosis of postoperative vascular complications. This review focuses on the role of conventional gray-scale ultrasound, Doppler ultrasound and CEUS for early diagnosis of vascular complications after adult LDLT.

Keywords: Living donor liver transplantation; Vascular complications; Ultrasonography; Doppler ultrasound; Contrast-enhanced ultrasound

Core tip: Vascular complications are among the most severe complications after living donor liver transplantation (LDLT), which may lead to graft loss and death of the recipients. Conventional gray-scale and Doppler ultrasound, contrast-enhanced ultrasound (CEUS) play important roles in identifying vascular complications in the early postoperative period and during follow-up. This review focuses on the current applications of conventional ultrasound and CEUS in the diagnosis of vascular complications in the early period after adult LDLT, including the diagnostic efficacy, controversial diagnostic criteria and current issues requiring further investigations.