RADIOLOGICAL INTERVENTION IN POSTOPERATIV E COMPLICATIONS FOLLOWING LIVER-TRANSPLANTATION

Purpose: Postoperative complications contribute significantly to the m orbidity and mortality of liver transplant patients. The management of these complications re quires a multidisciplinary approach in which i nterventional radiology plays an integral role. Indications, technique s, and results of radiological interventions in the management of the liver transplant patient are presented. Material and methods: During a 10-year period, 52 out of 420 liver transplant recipients underwent r adiological interventions, including angioplasty (n = 20), embolizatio n (n = 2), percutaneous drainage (n = 11), and biliary interventions ( n = 19). Results: Nine out of ten arterial stenoses located at the ana stomoses (n = 8), within the liver (n = 1) and in the coeliac trunk (n = 1) were successfully treated by balloon dilatation. Angioplasty of supra- or infrahepatic anastomotic stenoses of the IVC (n = 5) provide d long-term success only in combination with stent implantation. Porta l vein stenoses and chronic thrombosis were treated by balloon dilatat ion and stent insertion via transhepatic catheterization of the portal vein. Late strictures of bile-duct anastomoses can be managed by ante - or retrograde interventions. If biliary complications are related to inflammatory or septic problems, the prognosis of graft survival is p oor. Conclusion: Interventional radiological procedures are very usefu l in the management of vascular and biliary complications after liver transplantation. These techniques provide a cure in many situations, a nd thus, surgical interventions may be avoided in selected cases.