*Purpose: The purpose of this study was to assess the utilization of doppler ultrasound in the immediate post-operative period of liver transplant patients. We hypothesized post-operative ultrasound findings do not correlate with change in medical management of liver transplant patients.

*Methods: We conducted a retrospective cohort study of consecutive adult liver transplants performed from 2013 – 2017. The difference across compared groups for continuous variables was assessed using the independent sample t-test and for binary variables using the chi-square test. The statistical significance for all comparisons was set at 5%.

*Results: There were 451 liver transplants performed with a corresponding 992 ultrasounds performed post operatively. During the transplant admission, forty percent of patients received one ultrasound, 33% had two ultrasounds and 27% required three or more. Within the first 24-hours, 383 ultrasounds were performed with 6% of patients having subsequent change in management (p=0.18). The first 48-hours yielded an additional 129 ultrasounds and 16% of those patients experienced a change in management post ultrasound (p=0.29). Overall, patients with an in-hospital stay of ≤7 days received significantly fewer ultrasounds compared with patients who stayed longer (p<0.001).

*Conclusions: While liver doppler ultrasounds are routinely performed within the first 24-48 hours post liver transplantation, ultrasound results are not associated with change in management of the liver transplant patient. More research is needed to identify subgroups of patients who might potentially benefit from use of ultrasound as a diagnostic or prognostic tool in the immediate post-operative period of a liver transplant.

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