title: Postoperative gastrointestinal bleeding after an orthotopic liver transplant: a single-center experience.
abstract: OBJECTIVE
  The overall incidence, causes, and treatment of posttransplant gastrointestinal bleeding, have been previously described. In this study, we examined the causes and treatment of postoperative gastrointestinal bleeding after orthotopic liver transplant.
  
  
  METHODS
  Clinical data of 335 patients who underwent an orthotopic liver transplant at our institution between September 2001 and December 2012 were analyzed retrospectively. The diagnosis and treatment of postoperative gastrointestinal bleeding after an orthotopic liver transplant were reviewed.
  
  
  RESULTS
  Gastrointestinal bleeding occurred in 13 patients (3.8%) after an orthotopic liver transplant. Five patients (38.4%) were adult and 8 patients (61.6%) were pediatric. The sites of the bleeding were Roux-en-Y anastomosis bleeding in 5 cases, peptic ulcer in 3 cases, erosive gastritis in 3 cases, gastric and esophageal varices in 1 case, and hemobilia in 1 case. These 13 patients with gastrointestinal bleeding were managed with conservative treatment, endoscopic treatment, radiologic interventional embolism, or exploratory laparotomy. No patients died because of gastro--intestinal bleeding. During follow-up, 4 patients died because of sepsis and 1 patient died of recurrence of hepatocellular carcinoma.
  
  
  CONCLUSIONS
  Gastrointestinal bleeding after liver transplant and its incidence, causes, and treatment are not well-described in the literature. Diagnosis and management of gastrointestinal bleeding requires a multidisciplinary approach involving surgeons, hepatologists, advanced and experienced endoscopists, and interventional radiologists.
authors.affiliation: Department of Family Physician, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Fidan
authors.forename: Mahir
authors.initials: M
authors.lastname: Kırnap
authors.forename: Aydıncan
authors.initials: A
authors.lastname: Akdur
authors.forename: Figen
authors.initials: F
authors.lastname: Özçay
authors.forename: Haldun
authors.initials: H
authors.lastname: Selçuk
authors.forename: Gülnaz
authors.initials: G
authors.lastname: Arslan
authors.forename: Gökhan
authors.initials: G
authors.lastname: Moray
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006489:Hemostatic Techniques; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult