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Deborah Rubens, MD
Doppler Imaging of Liver Transplants: Diagnoses and Dilemmas
Deborah Rubens, MD
09/28/2014 | Time : 30 min
About This Lecture:

A discussion about imaging liver transplants. List some indications for Doppler of the liver. Discuss the ultrasound protocol for interrogating a liver transplant. List post-liver transplant complications that may be seen with ultrasound.

Topics mentioned in this video : Background, USA- liver transplantation 2009, Total adult liver transplants, Liver transplants: what are the key vascular connections, Normal piggyback anastomosis limits IVC to one connection, Imaging protocol, Post-operative liver transplant, Hepatic artery, HAS/HAT disastrous complication, Dx of HA thrombosis/stenosis, Rising LFTs post-op txp, Abnormal LFTs – HAS?, Low RIs – HAS?, Adult LRD right liver allograft HAT with normal RIs, Spectral Doppler and RIs first ten days post-op, Do high RIs predict HAT?, Spectral waveforms of 56 patients with HAT days 0-10, Absent diastolic flow, Management of non-vis HA, Improved HA visualization with US contrast, HAS?, 6 weeks post angioplasty, Selective HA arteriogram stent placed, One month later, Six months later, IVC and hepatic venous outflow obstruction, IVC thrombosis and stenosis, Post-transplant complications: IVC, Post-transplant complications: hepatic veins, Symptomatic HV stenosis elevated hepatic wedge pressures required IVC revision, IVC stenosis related donor, Portal vein complications, Portal vein thrombosis post liver transplant initial exams normal, Day 1, Day 2, Day 3, Portal vein stenosis, PV stenosis?, Portal vein stenosis, Post-transplant hepatic CT, Post stent, Portal vein thrombosis?, CT images, Following decompression, Asymptomatic patient low RIs, HA-PV fistula, HA pseudoaneurysms, Arterial steal syndrome, Sonographic images, Post coiling, PV steal, Poor portal vein flow in perioperative period; patient returned to OR, Large splenorenal varices shunted flow from PV, 5 months post-transplant – portal vein thrombosis, Embolization of varices and thrombectomy of portal vein re-establishes flow, OLTxp with jump graft; what would you do?, Day 4, Conclusions, Thank you

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Keywords : allograft, arterial steal, color Doppler, HA pseudoaneurysm, HA, has, HAT, hepatic artery – portal vein fistula, hepatic artery stenosis, hepatic artery thrombosis, hepatic artery, hepatic transplant, hepatic vein, inferior vena cava, IVC stenosis, IVC thrombosis, IVC, jump graft, left hepatic artery, left hepatic vein, left portal vein, LFTs, LHV, liver Doppler, liver function tests, liver transplant, low RIs, LPV, main hepatic artery, main portal vein, MHV, middle hepatic vein, MPV, OLT, orthotopic liver transplant, portal vein stenosis, portal vein thrombosis, portal vein, portal veins steal, resistive index, RHV, RI, right hepatic artery, right hepatic vein, RPV, spectral Doppler, splenorenal shunt

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