Liver Transplant Guidebook 1

xz 1 LIVER TRANSPLANTATION CASE EXAMPLES 8.5 Detect compromised anastomosis with TTFM and HFUS These TTFM tracings are from the Hepatic Artery. The first measurement showed low flow of 66 ml/min with a jagged flow curve, indicating a possible compromised anastomosis. After revision of the anastomosis, HA flow improved to 248 ml/min with a pulsatile flow curve. 8.6 Guide inflow modulation with TTFM These TTFM tracings are from the Portal vein and the Hepatic artery. The Portal vein flow (PVF) was lower than expected, only 969 ml-/rnin, and a spleno-renal shunt was identified. This shunt caused hepatotugal flow. After Closure Of this Shunt, PVF improved to 1,808 mL/min. Reduced hepatofugal flow (flow directed away from the liver) increases the chance for graft survival.