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Author Notes:

Corresponding Author: Nitika Arora Gupta, MD, DCH, DNB, MRCPCH, Assistant Professor of Pediatrics, 1780 Haygood Drive, Atlanta, GA 30322, Phone: 404-727-2026, Facsimile: 404-727-4069, Email: naroraq@emory.edu

VK: Designed and conducted the experiments, analyzed results and drafted the manuscript

RJ: Conducted the IRI surgeries and ultrasound measurements

CA: Analyzed the histology slides and did critical revisions to the manuscript

NG: Designed and directed the study with interpretation of data and critical revisions to the manuscript. Agrees to be accountable for all aspects of the work.

The authors declare that they have no conflicts of interest relevant to this work


Research Funding:

This work was supported by a grant from the Children’s Digestive Health and Nutrition Foundation and a K08 grant from the NIH.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Gastroenterology & Hepatology
  • Nutrition & Dietetics
  • Pediatrics
  • Doppler ultrasound
  • fatty liver
  • ischemia reperfusion injury
  • nontargeted contrast microbubbles
  • perfusion index
  • sinusoidal space
  • FLOW
  • RAT

Contrast-Based Real-Time Assessment of Microcirculatory Changes in a Fatty Liver After Ischemia Reperfusion Injury


Journal Title:

Journal of Pediatric Gastroenterology and Nutrition


Volume 62, Number 3


, Pages 429-436

Type of Work:

Article | Post-print: After Peer Review


A fatty liver is known to have impairment of microcirculation, which is worsened after ischemia reperfusion injury (IRI). This makes most fatty grafts unsuitable for transplantation, and in the absence of real time assessment of microcirculation this selection has been at best, random. The goal of this study was to demonstrate the utility of a contrast enhanced ultrasound model in quantitative assessment of the microcirculation of a fatty liver. We subjected fatty mice to IRI and blood flow dynamics were assessed before and after the injury. There was a significant increase in the resistive and pulsatility index of the extra hepatic artery and a significant decrease in velocity of the portal vein. There was also a quantifiable decrease in the intrahepatic blood volume, blood flow, time to peak flow, and perfusion index of mice with fatty liver suggesting that a fatty liver develops hemodynamic abnormalities after IRI, leading to increased hepatocellular injury. Importantly, these abnormalities can be reliably quantified by using a contrast, enhanced Doppler ultrasound, an inexpensive technique with multiple clinical applications. It can be used to assess the quality of the fatty liver donor graft prior to organ retrieval; for determining live donor candidacy, for making post IRI recovery prognosis, and for assessing the effectiveness of therapeutic interventions.

Copyright information:

© 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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