Preliminary report: hepatic vein Doppler in the early diagnosis of acute liver transplant rejection.

37 transplanted livers (in thirty patients) were assessed by serial doppler ultrasound examination. 18 of 23 biopsy-proved rejection episodes were associated with abrupt damping of the normally pulsatile blood flow of the hepatic veins. In the other 5 episodes, the waveforms were damped at the outset by perioperative ischaemia. There were no rejection episodes with normal traces. Another cause of damping was cholangitis (5 episodes), but this was distinguishable clinically and biochemically. There were no episodes of rejection with normal hepatic vein traces. Serial doppler examination, in combination with clinical evaluation, may allow earlier diagnosis and treatment of liver rejection.