Advances in pediatric liver transplantation: continuous monitoring of portal venous and hepatic artery flow with an implantable Doppler probe.

Background. Acute vascular thrombosis is a dreaded complication in solid organ transplantation. Pediatric liver transplantation is associated with a high incidence of hepatic artery thrombosis. Graft salvage is dependent upon early recognition and correction of the thrombosis. Current methods of surveillance for vascular thrombosis lack early detection. Methods. Four consecutive pediatric liver transplantations were performed using the implantable Doppler probe to monitor the patency of the hepatic artery and the portal vein during the early postoperative period. Results. The implantable Doppler probes provided reliable monitoring of vascular patency. Early detection of hepatic artery thrombosis, with subsequent correction and graft salvage, was achieved with the use of the implantable Doppler probe. Conclusions. The implantable Doppler probe provides real-time surveillance of vascular patency for up to 7 days in the postoperative period. Signal quality and character was easily assessed by physician and nursing staff and reliably reflected intravascular flow.