Purpose or Case Report: It is well known that ultrasound is a powerful imaging tool for pediatric patients after liver transplantation. With proper use, ultrasound provides static as well as dynamic information of the transplanted liver. The purpose of this educational exhibit is to demonstrate the way of good ultrasound examination after pediatric liver transplantation.
Methods & Materials: Methods of this exhibit include the demonstration of the technical aspect of routine ultrasound examination after pediatric liver transplantation including tips and pitfalls.
Materials are provided by personal experience of more than 2,000 ultrasound examinations during recent 10 years since introduction of pediatric liver transplantation program at author’s institution. Majority of the patients are the recipients of a left lateral segment from living-donor liver transplantation. A small number of deceased donor liver transplantation recipients are also included.
Results: Routine postoperative ultrasound examination includes vascular analysis by means of color-coded imaging, and evaluation of liver parenchyma, intrahepatic bile duct, localized fluid collection surrounding the transplanted liver, pleural effusion, intraperitoneal fluid collection, and intestinal peristalsis and intestinal wall thickness. In regard to the evaluation of the vascular structure, RI and peak systolic velocity of the hepatic artery, mean velocity and flow volume of the portal vein, and maximum velocity of the hepatic vein are measured and recorded. Demonstration of the hepatic artery is sometimes technically demanding for example it located behind the portal vein. Careful evaluation of the vascular structure is mandate for early detection of their complications.
Conclusions: With high quality ultrasound examination after pediatric liver transplantation, precise selection of the candidate for further diagnostic test such as CT and/or MR imaging will be conducted. Accurate ultrasound result sounds good to transplant surgeon for prompt action in regard to therapeutic intervention.