الفهرس 
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Abstract
Liver transplantation became an accepted therapy for multiple liver diseases. Postoperative complications contribute significantly to the morbidity and mortality of liver transplant recipients; therefore postoperative imaging surveillance is important in minimizing the impact of complications. CDUS is the modality of choice for post operative recipient surveillance as it is non-invasive, portable and provides rapid, comprehensive and accurate detection of various complications after liver transplantation.
The aim of this study is to highlight the role of Doppler ultrasound in the evaluation of the post-operative recipient complications including vascular disorders, biliary disorders, liver parenchymal disorders and abdominal extrahepatic disorders.
This study was conducted on 60 recipients underwent living donor liver transplantation over a period of 25 months from Jan 2016 to Jan 2018 whom clinical data, laboratory data and Doppler ultrasonographic data raised the suspicious of postoperative complications.
All patients were subjected to the following:
Thorough history taking. Clinical examination. Laboratory investigations (serum bilirubin, SGOT, SGPT, serum alkaline phosphatase, serum albumin, prothrombin concentration, alpha-fetoprotein). Abdominopelvic ultrasonography. Doppler US. Suspected cases with complications underwent MSCT with three dimensional vascular reconstruction, conventional angiography, MRCP, fluid aspiration, analysis and biopsy for histo-pathological correlation.
The results of the current study showed that 47 patients (78.3%) hadvascular complications, 35patients (58.3%) hadbiliary complications, 15 patients (25%) had liver parenchymal complications, 16 patients (25%) had abdominal extrahepatic complications, 26 patients (43.3%) had fluid collections and 18 patients (30%) had pleural effusion.
The vascular complications were classified into arterial complications 21 patients (35%), portal complications 13 patients (21. 6%) and venous complications 8 patients (13.3%) .
The arterial complications detected by ultrasound showed 18 patients (69.2%) with tardus parvus wave and elevated systolic acceleration time SAT and 8patients (30.8)% with no arterial blood flow .
The sensitivity and specificity of color Doppler ultrasound in detection of arterial complications was 95% and 86%.
The sensitivity and specificity of color Doppler ultrasound in detection of portal complication was 88% and 90%.
The sensitivity and specificity of color Doppler ultrasound in detection of hepatic venous complication was 87% and 96%.
Biliary complications were divided into dilated CBD and IHBRD (suspected stricture) 20 patients (57.2%), perihepatic fluid collection 15 patients (42.8%) specially nearby the anastomotic site or cut surface of the graft (suspected leakage, biloma)
Liver parenchymal complications detected in this study were divided into abscess 5 patients(8.3%), infarctions and perfusion defect 8 patients(13.3%) , recurrent HCC 1 patient(1.6%) , lymphoproliferative disorders 1 patient(1.6%) and metastatic deposits 1 patient(1.6%).
Abdominal extrahepatic complications were classified into bowel perforation 1 patient(1.6%), ileus 2 patient(3.3%), incisional hernia 4 patients(6.6%), wound hematoma 2 patients(3,3%), splenic infarction 2 patients(3.3%),wound seroma 1 patient(1.6%), bowel congestion 3 patients(5%) and intraperitoneal hematoma 1 patient(1.6%).
Fluid collections are classified according to chemical nature into hemorrhagic 2 patients(3,3%), bilious 10 patients(16.6%), seroma 11 patients(18.3%) and pus 3 patients(5%).
Theconclusion of the current study confirmed that ultrasonography (US) is the preferred post-operative screening method because it is cost-effective, accessible, safe, non-invasive, and easily performed at bed-side. DU is often employed in the initial recipient work-up post-LDLT. DU is the imaging technique of choice to assess early and late surgical complications as it provides rapid, comprehensive and accurate evaluation of the entire hepatic vasculature and graft parenchymal abnormalities.