title: Incidence, management, and results of vascular complications after liver transplantation.
abstract: BACKGROUND
  Vascular complications show an 8%-15% incidence after liver transplantation and represent an important cause of mortality. An aggressive policy is necessary for an early diagnosis and treatment.
  
  
  METHODS
  From 2001 to 2009, we performed 240 liver transplantations in 232 patients. We employed Doppler ultrasonography on days 1 and 4 as well as before hospital discharge and always try a radiological approach.
  
  
  RESULTS
  The incidence of vascular complications was 7.2% (n = 18) including arterial (n = 12, 4.8%) of early thrombosis (n = 4), late thrombosis (n = 4), and stenosis (n = 4) or portal (n = 3; 1.2%) of thrombosis (n = 2) or stenosis (n = 1); or caval complications (n = 3, 1.2%). Radiologic therapy was effective in 1 patient with arterial stenosis, in the 3 patients with portal complications, and in 2 patients with caval complications. All patients with early thrombosis and 2/4 with late thrombosis required retransplantation. Surgical treatment was effective in 1 patient with late thrombosis, 3 with stenosis, and 2 with caval complications. The overall mortality rate was 16.6%; 2 patients with arterial complications and 1 with a caval complications.
  
  
  CONCLUSIONS
  Vascular complications, mainly artery complications, represent serious problem after liver transplantation, which often requires retransplantation. With an aggressive policy of diagnosis and treatment, we can decrease the mortality rate from these adverse events.
authors.affiliation: Surgery Department, Universitary Rio Hortega, Hospital Valladolid, Valladolid, Spain. perezsb@hotmail.com
authors.forename: B
authors.initials: B
authors.lastname: Pérez-Saborido
authors.forename: D
authors.initials: D
authors.lastname: Pacheco-Sánchez
authors.forename: A
authors.initials: A
authors.lastname: Barrera-Rebollo
authors.forename: E
authors.initials: E
authors.lastname: Asensio-Díaz
authors.forename: P
authors.initials: P
authors.lastname: Pinto-Fuentes
authors.forename: J C
authors.initials: JC
authors.lastname: Sarmentero-Prieto
authors.forename: P
authors.initials: P
authors.lastname: Rodríguez-Vielba
authors.forename: R
authors.initials: R
authors.lastname: Martínez-Díaz
authors.forename: M
authors.initials: M
authors.lastname: Gonzalo-Martín
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez
authors.forename: H
authors.initials: H
authors.lastname: Calero-Aguilar
authors.forename: R
authors.initials: R
authors.lastname: Pintado-Garrido
authors.forename: F
authors.initials: F
authors.lastname: García-Pajares
authors.forename: A
authors.initials: A
authors.lastname: Anta-Román
mesh_terms: D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects*; D018608:Ultrasonography, Doppler; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*