Fig. 27. Post-transplant hepatic vein stenosis: a 56-year-old woman status post-living donor liver transplantation 10 days previously with persistently increased liver function tests.

A, B. Grayscale (A) and color Doppler (B) ultrasonography show an echogenic, occlusive thrombus (arrows) in an accessory right inferior hepatic vein. There is no flow in the lumen on color Doppler imaging. C. Transverse grayscale ultrasonography shows a hypoechoic region (open arrows) in segment 6 that indicates a hepatic infarct due to venous outflow obstruction. D. Coronal contrast-enhanced computed tomography demonstrates an occlusive thrombus (arrow) in the accessory right inferior hepatic vein and congested hepatic parenchyma (open arrows) in segment 6. These findings were confirmed via exploratory laparotomy.