Vascular Complications of Liver Transplantation

This chapter discusses the background, prevention, diagnosis, treatment and prognosis of vascular complications following liver transplantation (LT). Vascular complications following LT generally fall into three categories: hepatic venous occlusion, portal vein thrombosis and hepatic artery thrombosis (HAT). LT requires a minimum of three, and very frequently four, vascular anastomoses to establish inflow and outflow to the allograft. Bleeding complications of these anastomoses are readily identified in the operating room, leaving anastomotic stenosis and thrombosis as the leading vascular complications encountered post-operatively. Surgical and radiologic approaches play complementary roles in the diagnosis and management of these potentially catastrophic complications, and early recognition is key to graft and patient survival.