Management of Vascular Complications

Liver transplantation (LT) is a well established surgical treatment option for patients with end stage liver diseases, with high operative success rates and survival benefits in both deceased donor and living donor liver transplantation (LDLT). The QMH liver transplant programme is the largest of its kind in China and Southeast Asia. By the end of October 2008, a total of 659 liver transplants have been performed with a 1-year, 3year and 5-year survival rates of 92%, 87% and 84% respectively. To ensure proper functioning of the liver graft, both arterial perfusion and venous drainage have to be sufficient and biliary ducts should not be obstructed. Vascular and biliary anastomosis must be patent without stenosis or leakage. Despite the success of liver transplantation in recent years based on improvements in surgical techniques and advances in immunosuppression, various complications still occur after liver transplantation1,2,3, resulting in significant patient mortality and morbidity. These complications may be categorised into vascular and biliary related groups. Radiology plays an important role in the diagnosis as well as in the therapeutic treatment of these complications4,5,6. This article describes how interventional radiology could be applied in the management of postoperative vascular and biliary complications in recipients after liver transplantation.