Study of Early Postoperative Doppler Changes Post Living Donor Liver Transplantation and Their Impact on Early Mortality and Small-for-Size Syndrome: A Retrospective Study

Background: Adult-to-adult living donor liver transplantation (LDLT) has been a common practice because of the deficiency of deceased donor liver transplants. Liver hemodynamics differ substantially between cases with end-stage liver disease undergoing LT because of various degrees of hepatic affection, nature of implicated causative factors, and pathogenesis of the hepatic disorder. The present retrospective study primarily aimed to study the early postoperative doppler changes after adult to adult LDLT. The secondary aim was to assess these hemodynamics' impact on early in-hospital deaths and small for size syndrome (SFSS) development. Methods: This retrospective work was done on 123 adult cases with end-stage liver disease for whom adult LDLT was performed after exclusion of pediatric patients and those with vascular complications. Results: Postoperative (PO) mean portal vein velocity (PVV), hepatic artery (HA) peak systolic velocity (PSV), and HA resistivity index (RI) declined gradually but significantly post adult LDLT. Phasicity of hepatic veins changes towards the triphasic waveform gradually in the early PO period. There is a notable negative relationship between PO mean PVV with PO mean HA PSV. Higher PO HA RI affected PO mortality, while higher PO PVV and lower HA PSV increased the incidence of SFSS. Conclusion: Early postoperative Doppler changes post-LDLT (PO PVV, HA RI, and HA PSV) can affect both mortality and SFSS development.