Hepatic artery thrombosis and infarction: evolution of the ultrasound appearances in liver transplant recipients.

Hepatic infarction is a serious complication of liver transplantation, causing significant morbidity and mortality and often requiring retransplantation. Real time ultrasonography with Doppler examination is often the first imaging modality employed to investigate post-operative complications. We report on the sonographic appearances of three patients in whom hepatic infarction followed transplantation but who did not require retransplantation, allowing us to study the evolution of sonographic features. Geographic areas of decreased echogenicity with preservation of the portal tracts are an early sign of hepatic ischaemia and may either resolve completely or progress to true infarction with the development of transient small hyperechoic lesions. Calcification may also occur quite rapidly. Biliary strictures, bilomas and abscess formation are later complications.