Vascular complications following orthotopic liver transplantation

During the first 3 years of the Australian National Liver Transplantation Programme, 51 liver grafts were performed in 46 patients. There were 11 major vascular complications encountered following 10 liver transplants in eight (17%) patients. They caused death in three patients and the need for retransplantation in two others. Hepatic artery thrombosis (HAT) occurred five (10%) times, producing a spectrum of clinical illness ranging from death to an asymptomatic event. Other vascular complications included hepatic artery stenosis not complicated by thrombosis (two), primary (one) and secondary (one) haemorrhage, thrombosis of a mesoportal venous graft (one) and inferior vena caval stenosis (one). Vascular complications are a significant cause of morbidity and mortality following liver transplantation. Predisposing and precipitating factors should be recognized and minimized.