ABSTRACT

Liver transplantation is the most effective treatment for fulminant hepatic failure, end-stage liver disease, some rare, inherited metabolic disorders, and in selected cases of hepatobiliary malignancy. Advanced surgical techniques and sophisticated immunosuppressive regimens have yielded improvements in patient and graft survival. Many factors contribute to possibility of complications during or following liver transplantation. The patient’s general condition, performance status, comorbid conditions, degree of hepatic decompensation, and even psychosocial factors may impact risk of complications. This chapter discusses complications related to liver transplant are presented and are stratified according to whether they originate as liver graft or systemic/extra-hepatic problems. Respiratory failure requiring prolonged mechanical ventilation can result from recipient deconditioning, underlying parenchymal lung disease, or hepatopulmonary syndrome. Injury to right phrenic nerve during native liver hepatectomy can lead to right hemidiaphragmatic paralysis. Renal insufficiency is common after liver transplantation, especially in patients with preexisting intrinsic kidney disease and/or in those with acute kidney injury or hepatorenal syndrome immediately prior to transplantation.