Farbkodierte Duplexsonographie vor und nach Lebertransplantation bei Kindern

In the current work the diagnostic value of ultrasound in infants with severe, end-stage liver disease for preoperative evaluation and for early follow-up subsequent to orthotopic liver transplantation were examined in a retrospective fashion. The nature of complications which can be judged accurately by means of ultrasound and the necessity of further tomographic imaging were assessed. A total of 43 infants who underwent liver transplantation surgery in our clinic within a period from September 2006 to June 2009 were assessed by preoperative and postoperative ultrasound. The imaging findings were analyzed in a retrospective fashion and the data were compared with the medical literature. Preoperative ultrasound examinations showed complex vascular anomalies with significance to the surgeon in 3 infants. Post-transplantation ultrasound revealed 10 vascular complications related to the transplant (2 occlusions of the hepatic artery, 2 cases of portal vein thrombosis and 6 cases with a stenosis of the portal vein anastomosis). Thus, the cumulative incidence of vascular complications was 23.3%. In conclusion ultrasound is a very sensitive modality for follow-up examinations subsequent to liver transplantation and preoperative examination. The transplant and the vasculature can be accurately judged without the need for further tomographic imaging. Thus, ultrasound is the modality of choice for preoperative evaluation and postoperative follow-up of infants receiving orthotopic liver transplants.