Upper inferior vena caval anastomotic stenosis in liver transplant recipients: Doppler US diagnosis.

Ultrasound (US) is routinely used as a screening tool for liver transplant dysfunction. Its use in the detection of significant vascular complications of liver transplantation such as thrombosis or stenosis of the hepatic artery and portal vein is well recognized. Its role in the detection of anastomotic stenosis of the inferior vena cava (IVC) has not been defined. The authors present US findings in five patients with such stenosis. The gray-scale and Doppler findings in all cases consisted of loss of normal hepatic vein and IVC periodicity. Some studies also showed distention of the hepatic veins and IVC and a high-velocity jet at the anastomosis, and in one case the stenosis was visualized with color Doppler US. While there are other causes of absent periodicity in the hepatic veins, this finding in the appropriate clinical setting may be a sensitive indicator of upper IVC anastomotic stenosis.