Emergencies Following Orthotopic Liver Transplant

Abstract

Complications following lifesaving liver transplantation can be devastating and must be managed properly to optimize the patient and allograft survival. There are non-immune, non-infectious complications which present a severe risk to survival of both the patient and the allograft. These include primary graft non-function (PNF) and hepatic artery thrombosis (HAT). Other complications manifest less urgently but continue to represent potentially lethal consequences to both the patient and the hepatic allograft. These include vena cava outflow disruptions, portal venous outflow derangements, and portal vein thrombosis (PVT). Successful management of these complications is optimized with a multidisciplinary approach to the care of liver transplant recipients. We describe their definition, epidemiology, pathophysiology, related factors, presentation, operative and non-operative management, outcomes, and future directions of these potentially catastrophic complications.