Zhao NB, Luo Z, Li Y, Xia R, Zhang Y, Li YJ, Zhao D. Diagnostic value of ultrasonography for post-liver transplant hepatic vein complications. World J Transplant 2025; 15(2): 100373 [DOI: 10.5500/wjt.v15.i2.100373]
Corresponding Author of This Article
Dong Zhao, MD, Doctor, Chief Doctor, Professor, Department of Liver Surgery and Organ Transplantation Center, Shenzhen Third People's Hospital, The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, No. 29 Bulan Road, Longgang District, Shenzhen 518112, Guangdong Province, China. zdong1233@126.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
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/
Ning-Bo Zhao, Zi Luo, Ying Li, Yu Zhang, Yi-Jun Li, Department of Ultrasound, National Clinical Research Centre for Infectious Disease, Shenzhen Third People’s Hospital, The Second Hospital Affiliated With The Southern University of Science and Technology, Shenzhen 518112, Guangdong Province, China
Rui Xia, Department of Thyroid and Hernia Surgery, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
Dong Zhao, Department of Liver Surgery and Organ Transplantation Center, Shenzhen Third People’s Hospital, The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen 518112, Guangdong Province, China
Author contributions: Zhao NB and Zhao D were responsible for provision of study materials or patients, data analysis and interpretation; Zhao NB, Luo Z, Li Y, Xia R, Zhang Y, Li YJ were responsible for collection and assembly of data; Zhao D was responsible for conception, design, and administrative support; Zhao NB, Luo Z, Li Y, Xia R, Zhang Y, Li YJ, and Zhao D were responsible for manuscript writing; all of the authors read and approved the final version of the manuscript to be published.
Supported by The Shenzhen Science and Technology Research and Development Fund, No. JCYJ20220530163011026 and No. JCYJ20210324131809027; and The Shenzhen Medical Key Discipline Project, No. G2021008 and No. G2022008.
Conflict-of-interest statement: The authors have no conflict-of-interest to report.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong Zhao, MD, Doctor, Chief Doctor, Professor, Department of Liver Surgery and Organ Transplantation Center, Shenzhen Third People's Hospital, The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, No. 29 Bulan Road, Longgang District, Shenzhen 518112, Guangdong Province, China. zdong1233@126.com
Received: August 14, 2024 Revised: January 9, 2025 Accepted: January 18, 2025 Published online: June 18, 2025 Processing time: 190 Days and 20 Hours
Abstract
Liver transplantation (LT) is the most effective treatment for patients with end-stage liver disease, and maintaining vascular patency of the transplanted liver is one of the crucial prerequisites for surgical success. Despite hepatic vein complications following LT occurring at a relatively low frequency, ranging between 2% to 11%, delayed diagnosis and treatment may lead to graft dysfunction and even patient mortality. Clinical manifestations of hepatic vein complications are often subtle and nonspecific, posing challenges for early diagnosis. Signs may initially present as mild abnormalities in liver function, delayed recovery of liver function, unexplained ascites, lower limb edema, and perineal edema. Prolonged duration of these complications can lead to hepatic sinusoidal dilatation and eventual liver failure due to prolonged hepatic congestion. Ultrasonography has become the preferred imaging modality for post-liver transplant evaluation due to its convenience and non-invasiveness. Although hepatic vein complications may manifest as disappearance or flattening of the hepatic vein spectrum on routine ultrasound imaging, these findings lack specificity. Contrast-enhanced ultrasound that visualizes the filling of contrast agent in the hepatic veins and dynamically displays blood flow perfusion information in the drainage area can, however, significantly improve diagnostic confidence and provide additional information beyond routine ultrasound examination.
Core Tip: Clinical manifestations of hepatic vein complications are often subtle and nonspecific. Signs may initially present as mild abnormalities in liver function, delayed recovery of liver function, unexplained ascites, and perineal edema. Prolonged duration of these complications can lead to hepatic sinusoidal dilatation and eventual liver failure due to prolonged hepatic congestion. Ultrasonography has become the preferred imaging modality for post-liver transplant evaluation. Contrast-enhanced ultrasound that visualizes the filling of contrast agent in the hepatic veins and dynamically displays blood flow perfusion information in the drainage area can, however, significantly improve diagnostic confidence and provide additional information beyond routine ultrasound examination.
