Contrast-enhanced ultrasonography to evaluate risk factors for short-term and long-term outcomes after liver transplantation: A pilot prospective study
December 14, 2020 — European Journal of Radiology
To evaluate whether Doppler ultrasonography (DUS) and contrast-enhanced ultrasonography(CEUS) can identify liver donation after brain death (DBD) and cardiac death (DCD)with the risk of developing short-term primary graft dysfunction (PGD) or arterialand biliary complications within 1 year.
Materials and methods
Consecutive DBD and DCD donors who underwent DUS/CEUS examinations before surgicalprocurement from February 2016 to June 2018 at our institution were included. TheUS and CEUS images of each donor liver were analysed, and the parameters were recorded.
The mean time for US examination was 32 min (range, 20-59 min), and all donors toleratedthe examination well. In terms of short-term outcomes, among the 52 eligible donorlivers, 20 (38.5%) of their recipients developed PGD. The multivariable analysis showedthat decreased enhancement of donor livers on CEUS (OR = 15.976, 95% CI: 1.652-154.628,P = 0.017) and high recipient model for end-stage liver disease (MELD) scores (OR = 1.050,95% CI: 1.004-1.099, P = 0.034) before liver transplantation (LT) were independentfactors of PGD. In contrast, for long-term complications, among the 48 eligible donorlivers, 16 (33.3%) developed arterial or biliary complications within 1 year. Themultivariable analysis did not show any independent factors of arterial or biliarycomplications within 1 year.
A decrease in enhancement on CEUS is an independent risk factor for poor short-termoutcomes of LT. CEUS may be promising for predicting post-LT outcomes of criticallyill donors effectively and safely by evaluating the haemodynamic changes in DBD andDCD donor livers.
Authors: Bo-wen Zheng; Hong-jun Zhang; Shi-jie Gu; Tao Wu; Li-li Wu; Yu-fan Lian; Ge Tong; Shu-hong Yi; Jie Ren
Read full text at: https://doi.org/10.1016/j.ejrad.2020.109475