What are the possible complications of whole-liver orthotopic liver transplantation (OLTX)?

Updated: Nov 11, 2019
  • Author: Fazal Hussain, MD, MPH; Chief Editor: John Karani, MBBS, FRCR  more...
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During a standard whole-liver orthotopic liver transplantation (OLTX), the following 4 donor structures must be reconnected sequentially from posterior to anterior to the recipient counterparts:

  • Retrohepatic inferior vena cava (IVC)

  • Main portal vein (MPV)

  • Hepatic artery

  • Extrahepatic bile duct

Complications of OLTX can be mechanical or nonmechanical. Not surprisingly, postoperative mechanical complications are related to problems with the hepatic artery, bile ducts, MPV, and IVC. Nonmechanical complications include allograft nonfunction, rejection, viral reinfection of the transplanted liver by the host, recurrent hepatic malignancy, and posttransplantation lymphoproliferative disease (PTLD). [25] Imaging is important in the detection, evaluation, and (in some instances) nonoperative interventional treatment of mechanical complications. Imaging plays less of a role in the workup of nonmechanical complications of OLTX.

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