Hepatic Artery Resistance Index at Doppler Ultrasonography Is a Useful Parameter of Hepatic Graft-vs-Host Disease After Allogeneic Stem Cell Transplantation

• Published in: Transplantation proceedings Vol. 42; no. 9; pp. 3717 - 3722
• Main Authors: Song, M.-K, Chung, J.-S, Kim, S, Seol, Y.-M, Kim, S.-G, Shin, H.-J, Choi, Y.-J, Cho, G.-J
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.11.2010; Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; Cardiovascular system; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft vs Host Disease - diagnostic imaging; Graft vs Host Disease - etiology; Graft vs Host Disease - mortality; Graft vs Host Disease - physiopathology; Hepatic Artery - diagnostic imaging; Hepatic Artery - physiopathology; Humans; Investigative techniques, diagnostic techniques (general aspects); Kaplan-Meier Estimate; Korea; Liver Diseases - diagnostic imaging; Liver Diseases - etiology; Liver Diseases - mortality; Liver Diseases - physiopathology; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Preoperative Care; Proportional Hazards Models; Risk Assessment; Risk Factors; Stem Cell Transplantation - adverse effects; Stem Cell Transplantation - mortality; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tissue, organ and graft immunology; Transplantation, Homologous; Treatment Outcome; Ultrasonic investigative techniques; Ultrasonography, Doppler; Vascular Resistance; Young Adult; Sonography; Hepatic artery; Doppler ultrasound study; Immunopathology; Graft versus host disease; Stem cell; Hematopoietic cell; Homograft; Hepatic disease; Index; Transplantation; Medicine; Treatment; Vascular resistance; Surgery; Digestive diseases; Graft; Parameter
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.08.041

Abstract The hepatic artery resistance index (HARI) reflects portal venous blood pressure and resistance in several diseases of the liver. This study investigated whether preconditioning HARI values would predict hepatic complications such as hepatic graft-vs-host disease (GvHD), veno-occlusive disease, and drug- and sepsis-related hepatotoxicity after allogeneic stem cell transplantation (SCT). Fifty-nine patients who underwent allogeneic SCT were studied to determine whether pre-SCT HARI would predict post-SCT hepatic complications. Twenty-six patients (44.1%) had high HARI values (≥0.74) before allogeneic SCT. At univariate analysis, a high HARI value correlated with incidence of hepatic GvHD. Multivariate analysis revealed that a nonmyeloablative regimen ( P = .009; hazard ratio [HR], 4.05), infused CD34-positive cell dosage ( P = .01; HR, 3.32), and high HARI ( P = .02; HR, 2.82) were independent predictors. However, a high HARI did not correlate with nonrelapsed mortality and overall survival. In conclusion, it seems that a high HARI before SCT might be an important predictor of significant hepatic GvHD in patients after allogeneic SCT.