Use of Intraoperative Doppler Ultrasonography in Predicting Life-Threatening Vascular Complications After Adult Deceased Donor Liver Transplantation.

Autor:	O'Leary C; Department of Surgery, Saint Louis University School of Medicine, St. Louis, USA., Spence S; Department of Surgery, Saint Louis University School of Medicine, St. Louis, USA., Wells RM; Department of Surgery, Saint Louis University School of Medicine, St. Louis, USA., Sculley D; Department of Surgery, Saint Louis University School of Medicine, St. Louis, USA., Bettag J; Department of Surgery, Saint Louis University School of Medicine, St. Louis, USA., Okeke RI; Department of Surgery, Sisters of St. Mary (SSM) Health Saint Louis University Hospital, St. Louis, USA., Shoela R; Department of Radiology, Saint Louis University Hospital, St. Louis, USA., Nazzal M; Department of Surgery, Saint Louis University Hospital, St. Louis, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Nov 13; Vol. 16 (11), pp. e73588. Date of Electronic Publication: 2024 Nov 13 (Print Publication: 2024).
DOI:	10.7759/cureus.73588
Abstrakt:	Aim This study aims to determine if routine use of intraoperative Doppler ultrasonography is preventative of life-threatening vascular complications (VCs) after orthotopic liver transplantation. Methods This single-center, retrospective study reviewed all adult orthotopic liver transplants at Saint Louis University Hospital from 2015 to 2020 (N = 188). The sample population consists of men and women in the age range of 18 to 75. Operative reports were reviewed for the use of intraoperative ultrasound (IOUS) and the associated resistive indices, peak systolic velocities, and qualitative assessments of flow. Postoperative VCs were identified as complications requiring intervention between the time of transplant and December 31, 2020. Life-threatening VCs were defined by the presence of vascular thrombosis. The primary outcome was the incidence of postoperative life-threatening VCs between those in which intraoperative DUS was performed and those in which it was not. Results IOUS was documented in 35 (18.6%) cases. All cases using IOUS demonstrated good flow and no abnormalities, as reported by the operating surgeon. There was no difference in patient population between those who received IOUS and those who did not. Postoperative life-threatening VCs were identified in five cases. Of the cases in which no IOUS was performed, five (3.3%) had life-threatening VCs. Of the patients with documented IOUS, 0 (0%) had life-threatening VCs. Conclusions The IOUS group showed a lower incidence of life-threatening VCs (0%) compared to the no IOUS group, which had a 3.3% life-threatening complication rate. However, this was not statistically significant due to the small number of VCs, as VCs following liver transplants are inherently rare. With these results in combination with current literature, there is support for the use of IOUS in preventing and predicting VCs. Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Saint Louis University issued approval 32285. The Saint Louis University institutional review board approved the study (IRB #32285) and waived patient consent requirement due to the retrospective, de-identified nature of the study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, O'Leary et al.)
Databáze:	MEDLINE
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