Duplex Doppler evidence of high hepatic artery resistive index after liver transplantation: Role of portal hypertension and clinical impact
| Autor: | Alfonso Wolfango Avolio, Salvatore Lucio Cutuli, A Franco, R. Gaspari, Alessandro Cina, Vittorio Mignani, Massimo Antonelli, Luciana Teofili, Salvatore Agnes, Caterina Giovanna Valentini |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Settore MED/18 - CHIRURGIA GENERALE Spleen Liver transplantation Duplex Doppler ultrasonography Gastroenterology Sensitivity and Specificity 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Hypertension Portal medicine Humans Platelet Portal hypertension Retrospective Studies Outcome Creatinine Hepatology business.industry Ultrasonography Doppler Hepatic artery Middle Aged Resistive index medicine.disease Survival Analysis Settore MED/15 - MALATTIE DEL SANGUE medicine.anatomical_structure chemistry Risk factors 030220 oncology & carcinogenesis Multivariate Analysis 030211 gastroenterology & hepatology Female Vascular Resistance Hemoglobin business Blood Flow Velocity Artery |
| Popis: | Early increase of hepatic artery resistive index (HARI) is frequently observed after liver transplant (LTx).We aimed to investigate contributing factors and prognostic relevance of high HARI after LTx from deceased donor.We conducted a retrospective analysis of prospectively collected data from January 2017 and February 2019. According to the Duplex Doppler HARI values (3Among 81 LTx, 36 had a high HARI and 45 a normal HARI. Patients developing high HARI were older, exhibited lower platelet, hemoglobin, platelet count/spleen diameter ratio, higher serum creatinine, and a more pronounced spleen enlargement (median values 170 versus 120 mm). At multivariate analysis, PLT/spleen diameter ratio (OR 0.994, p 0.001) creatinine levels (OR 2.418, p = 0.029), and recipient age (OR 1.157, p = 0.004) significantly predicted the occurrence of high HARI. Patients with high or normal HARI had similar vascular complications, rejection rate and 90-day mortality. In most cases, HARI recovered to normal without any clinical effect.HARI rises in presence of several surrogate markers of portal hypertension. The increase is mostly transitory, and it may result from the hepatic artery spasm due to the high portal blood flow. |
| Databáze: | OpenAIRE |
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