Liver transplantation (LT) is used to treat both adult and pediatric patients with end-stage liver disease or acute liver failure. It has become more prevalent as both the surgical technique and postoperative care have improved resulting in a reduced morbidity and mortality. As a result, there are more patients surviving longer after liver transplantation. Despite this, there remain serious complications from the procedure that have a significant outcome on the patient and may result in retransplantation. At the same time, there have been significant advances in the field of interventional radiology both in terms of technology and how these apply to the patients. In this paper, we review the commonest complications, diagnostic tests, and interventional management options available. 1. Introduction Liver transplantation (LT) is used to treat both adult and pediatric patients with end-stage liver disease or acute liver failure. It has become more prevalent as both the surgical technique and postoperative care have improved resulting in a reduced morbidity and mortality. As a result, there are more patients surviving longer after liver transplantation. Despite this, there remain serious complications from the procedure that have a significant outcome on the patient and may result in retransplantation. At the same time, there have been significant advances in the field of interventional radiology both in terms of technology and how these apply to these patients. The main advantage is the ability to treat the common complications via a percutaneous minimally invasive manner reducing the need for further surgery with the aim of preserving the function of the transplanted liver. As a result, interventional radiologists have become an important member in the multidisciplinary transplantation team. The commonest method of liver transplantation is an orthotopic type (OLT) where the donor organ is placed in the same anatomical location as the original. The techniques described in this paper apply to deceased donor LT and living related LT (LRLT) both in the adult and pediatric population. In this paper, we aim to review the common complications following liver transplantation, the diagnostic tools available, and the available interventional treatments including potential complications. This paper is a review of the range of procedures offered by the interventional radiologist and is a mix of our experience in one of the largest transplant centers in Europe—at our institutes, we currently perform over 180 adult and pediatric liver transplants per year—and a review
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