The utility of Doppler sonography for assessing the severity and treatment response of acute rejection in adult to adult living donor liver transplantation

Hiroshi Sadamori, Takahito Yagi, M. Inagaki, H. Matsuda, H. Matsukawa, Junji Matsuoka, S. Hamazaki, Susumu Kanazawa, N. Tanaka

Research output: Contribution to journalArticle

Abstract

Aim: We explored whether monitoring of graft hemodynamic changes by Doppler sonography can be useful for the treatment of acute rejection in adult to adult living donor liver transplantation (LDLT). Materials/Methods: 29 acute rejection episodes were confirmed by liver biopsy in 21 of 51 adult patients who underwent LDLT. We classified 29 acute rejection episodes into two groups based on the presence (n=8) or absence (n=21) of graft hemodynamic changes detected by Doppler sonography. The postoperative onset time of acute rejection episodes, the peak level of alanine aminotransferase (ALT), and Rejection Activity Index (RAI) were compared between two groups. The pattern of graft hemodynamic changes and response to treatment were analyzed. Results: Acute rejection episodes with graft hemodynamic changes (n=8) were characterized by earlier postoperative onset, higher levels of serum ALT and more severe RAI compared with acute rejection episodes without graft hemodynamic changes (n=21). The graft hemodynamic changes recorded in the former group included reduced mean portal venous flow velocity, pulsatile wave pattern of graft portal vein and increased peak systolic velocity of graft hepatic arterial flow. These graft hemodynamic changes could be reversed by effective antirejection therapy. Acute rejection episodes with graft hemodynamic changes are less likely to respond to steroid pulse therapy. Conclusions: These results suggested that monitoring of graft hemodynamic changes by Doppler sonography could assess the severity and treatment response of acute rejection, contributing to the precise selection of antirejection therapy after adult to adult LDLT.

Original languageEnglish
Pages (from-to)117-121
Number of pages5
JournalTransplantationsmedizin: Organ der Deutschen Transplantationsgesellschaft
Volume16
Issue number2
Publication statusPublished - 2004

Fingerprint

Doppler Ultrasonography
Living Donors
Liver Transplantation
Transplants
Hemodynamics
Therapeutics
Alanine Transaminase
Immunosuppression
Pulsatile Flow
Liver
Portal Vein
Steroids

Keywords

  • Acute rejection
  • Doppler sonography
  • Hemodynamic change
  • Living donor liver transplantation
  • Portal venous flow
  • Rejection activity index

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy

Cite this

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title = "The utility of Doppler sonography for assessing the severity and treatment response of acute rejection in adult to adult living donor liver transplantation",
abstract = "Aim: We explored whether monitoring of graft hemodynamic changes by Doppler sonography can be useful for the treatment of acute rejection in adult to adult living donor liver transplantation (LDLT). Materials/Methods: 29 acute rejection episodes were confirmed by liver biopsy in 21 of 51 adult patients who underwent LDLT. We classified 29 acute rejection episodes into two groups based on the presence (n=8) or absence (n=21) of graft hemodynamic changes detected by Doppler sonography. The postoperative onset time of acute rejection episodes, the peak level of alanine aminotransferase (ALT), and Rejection Activity Index (RAI) were compared between two groups. The pattern of graft hemodynamic changes and response to treatment were analyzed. Results: Acute rejection episodes with graft hemodynamic changes (n=8) were characterized by earlier postoperative onset, higher levels of serum ALT and more severe RAI compared with acute rejection episodes without graft hemodynamic changes (n=21). The graft hemodynamic changes recorded in the former group included reduced mean portal venous flow velocity, pulsatile wave pattern of graft portal vein and increased peak systolic velocity of graft hepatic arterial flow. These graft hemodynamic changes could be reversed by effective antirejection therapy. Acute rejection episodes with graft hemodynamic changes are less likely to respond to steroid pulse therapy. Conclusions: These results suggested that monitoring of graft hemodynamic changes by Doppler sonography could assess the severity and treatment response of acute rejection, contributing to the precise selection of antirejection therapy after adult to adult LDLT.",
keywords = "Acute rejection, Doppler sonography, Hemodynamic change, Living donor liver transplantation, Portal venous flow, Rejection activity index",
author = "Hiroshi Sadamori and Takahito Yagi and M. Inagaki and H. Matsuda and H. Matsukawa and Junji Matsuoka and S. Hamazaki and Susumu Kanazawa and N. Tanaka",
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TY - JOUR

T1 - The utility of Doppler sonography for assessing the severity and treatment response of acute rejection in adult to adult living donor liver transplantation

AU - Sadamori, Hiroshi

AU - Yagi, Takahito

AU - Inagaki, M.

AU - Matsuda, H.

AU - Matsukawa, H.

AU - Matsuoka, Junji

AU - Hamazaki, S.

AU - Kanazawa, Susumu

AU - Tanaka, N.

PY - 2004

Y1 - 2004

N2 - Aim: We explored whether monitoring of graft hemodynamic changes by Doppler sonography can be useful for the treatment of acute rejection in adult to adult living donor liver transplantation (LDLT). Materials/Methods: 29 acute rejection episodes were confirmed by liver biopsy in 21 of 51 adult patients who underwent LDLT. We classified 29 acute rejection episodes into two groups based on the presence (n=8) or absence (n=21) of graft hemodynamic changes detected by Doppler sonography. The postoperative onset time of acute rejection episodes, the peak level of alanine aminotransferase (ALT), and Rejection Activity Index (RAI) were compared between two groups. The pattern of graft hemodynamic changes and response to treatment were analyzed. Results: Acute rejection episodes with graft hemodynamic changes (n=8) were characterized by earlier postoperative onset, higher levels of serum ALT and more severe RAI compared with acute rejection episodes without graft hemodynamic changes (n=21). The graft hemodynamic changes recorded in the former group included reduced mean portal venous flow velocity, pulsatile wave pattern of graft portal vein and increased peak systolic velocity of graft hepatic arterial flow. These graft hemodynamic changes could be reversed by effective antirejection therapy. Acute rejection episodes with graft hemodynamic changes are less likely to respond to steroid pulse therapy. Conclusions: These results suggested that monitoring of graft hemodynamic changes by Doppler sonography could assess the severity and treatment response of acute rejection, contributing to the precise selection of antirejection therapy after adult to adult LDLT.

AB - Aim: We explored whether monitoring of graft hemodynamic changes by Doppler sonography can be useful for the treatment of acute rejection in adult to adult living donor liver transplantation (LDLT). Materials/Methods: 29 acute rejection episodes were confirmed by liver biopsy in 21 of 51 adult patients who underwent LDLT. We classified 29 acute rejection episodes into two groups based on the presence (n=8) or absence (n=21) of graft hemodynamic changes detected by Doppler sonography. The postoperative onset time of acute rejection episodes, the peak level of alanine aminotransferase (ALT), and Rejection Activity Index (RAI) were compared between two groups. The pattern of graft hemodynamic changes and response to treatment were analyzed. Results: Acute rejection episodes with graft hemodynamic changes (n=8) were characterized by earlier postoperative onset, higher levels of serum ALT and more severe RAI compared with acute rejection episodes without graft hemodynamic changes (n=21). The graft hemodynamic changes recorded in the former group included reduced mean portal venous flow velocity, pulsatile wave pattern of graft portal vein and increased peak systolic velocity of graft hepatic arterial flow. These graft hemodynamic changes could be reversed by effective antirejection therapy. Acute rejection episodes with graft hemodynamic changes are less likely to respond to steroid pulse therapy. Conclusions: These results suggested that monitoring of graft hemodynamic changes by Doppler sonography could assess the severity and treatment response of acute rejection, contributing to the precise selection of antirejection therapy after adult to adult LDLT.

KW - Acute rejection

KW - Doppler sonography

KW - Hemodynamic change

KW - Living donor liver transplantation

KW - Portal venous flow

KW - Rejection activity index

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