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Utility of nifedipine use for Doppler ultrasound early after liver transplantation to predict short-term complications and long-term outcomes

  • Hepatobiliary
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the response to nifedipine administration measured by changes in hepatic arterial (HA) flow on post-operative Doppler ultrasound (US) to predict short-term complications and long-term outcomes in liver transplant (LT) patients.

Methods

Patients who underwent LT with post-operative Doppler US within 3 days between 1 January 2005 and 31 December 2015 were included in this retrospective single center study. The patients who received and did not receive nifedipine during the Doppler US comprised the study and control groups, respectively. A positive response to nifedipine was defined as the detection of HA flow when none was present initially or a reduction in HA resistive index (RI) ≥ 0.1 after nifedipine administration. The rates of re-transplantation, re-operation, percutaneous intervention (PCI), and overall survival (OS) were recorded. Cox proportional hazards regression was used to evaluate the association of clinic-demographic variables and Doppler findings with the outcome measures.

Results

444 LT patients (305 M/139F, mean age 51.7 ± 17.4 years, mean interval between LT-Doppler US 1.12 ± 0.9 days) are presented. 220 patients comprised the nifedipine study group [n = 157/220 (71.4%) responder, n = 63/220 (28.6%) nonresponder] and 224 patients comprised the control group. There was no difference in re-transplantation or PCI rates between the groups (all p-values ≥ 0.2 and ≥ 0.08, respectively). The responder group had a lower rate of re-operation vs. the control group (15.9% vs. 24.1%, p = 0.03) and nonresponder group (15.9% vs. 31.8%, p = 0.004). 1-year and 2-year OS were similar between the groups (all p-values > 0.37).

Conclusion

Short-term complication rates and long-term outcomes for patients with liver transplant who responded to nifedipine administration on Doppler US are similar to those who did not require nifedipine administration. A lack of response to nifedipine was associated with a higher re-operation rate.

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Funding

No funding was received for conducting this study.

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Author notes

  1. Ally Rosen

    Present address: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA

Authors and Affiliations

  1. Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Gustave L Levy Place, Box 1234, New York, NY, 10029, USA

    Priyanka Kadaba, Laura Beitia, Ally Rosen, Sara Lewis & William L. Simpson

  2. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA

    Alan Weinberg

  3. BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA

    Sara Lewis

Authors
  1. Priyanka Kadaba
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  2. Laura Beitia
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  4. Alan Weinberg
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  5. Sara Lewis
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  6. William L. Simpson
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Contributions

Conceptualization: AR, WLS; Data collection: PK, LB, WLS; Statistical analysis: AW; Writing—original draft preparation: PK, WLS; Writing—review and editing: all authors. All authors read and approved the final manuscript.

Corresponding author

Correspondence to William L. Simpson.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This research study was conducted retrospectively from data obtained for clinical purposes. The study was approved the IRB of the Icahn School of Medicine at Mount Sinai with a waiver for informed consent from participants.

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Kadaba, P., Beitia, L., Rosen, A. et al. Utility of nifedipine use for Doppler ultrasound early after liver transplantation to predict short-term complications and long-term outcomes. Abdom Radiol 49, 1103–1112 (2024). https://doi.org/10.1007/s00261-023-04152-0

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  • DOI: https://doi.org/10.1007/s00261-023-04152-0

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