Introduction

Article Outline

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There is a growing population of patients worldwide that potentially require a liver transplantation. This large demand is disproportional to the relatively limited number of hepatic grafts available, whether the grafts are cadaveric or from living donors. Over the past two decades advances in surgical techniques, postoperative care, and antirejection regimens have prolonged the life expectancy of both hepatic grafts and transplant recipients. As a result, delayed vascular and biliary complications have been accentuated as causes of increased morbidity, graft loss, and mortality. In addition, it is possible that the reduction of graft losses due to rejection or early surgical complications has relatively increased the prevalence of delayed anatomic/surgical complications. Although still relatively uncommon, these complications are detrimental to patient quality of life and graft survival and, in turn, tax the limited graft pool.

Minimal invasive procedures, such as endoluminal, transhepatic, and endoscopic procedures, can help manage these complications and, as a result, potentially improve quality of life and graft survival. This issue discusses the techniques involved and the role of endoluminal and transhepatic interventional radiology procedures in the management of biliary and vascular complications in liver transplant recipients. In addition, the basic configurations of the surgical anatomy are discussed as well as the principles of invasive and noninvasive diagnostic imaging.

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