Intraperitoneal fluid collections following liver transplantation in a paediatric population

Reduced-size liver transplant techniques are now widely used in paediatric liver transplantation programmes. An argument against their use is the potential for an increased incidence of post-operative fluid collections arising from the cut surface of the liver. The distribution and management of fluid collections after 70 paediatric liver transplants (18 whole and 52 reduced), performed over a 3 year period is reported. Fluid collections occurred in seven of the whole liver transplant (WLT) group and in 23 of the reduced-size liver transplant (RLT) group. The incidence of fluid collections in the two groups was therefore similar (39% and 44%). Intervention was required in 20 collections: in the RLT group, seven of these were due to biliary anastomosis leaks or bowel perforation, the incidence of the remaining collections requiring intervention was similar in the two groups. In conclusion the overall incidence of fluid collections was not increased by the use of reduced-size liver transplants, and the increased rate of intervention in the RLT group was not related to the cut surface.