Article Text

  1. A. Fieker1,
  2. M. S. Sachdev1,
  3. M. K. Ismail1,
  4. C. R. Tombazzi1
  1. 1The University of Tennessee, Memphis, Memphis, TN.


Background Orthotopic liver transplantation is one of the most important treatments for people with cirrhosis of the liver. The 5-year survival in most centers around the United States is over 85%. As with any surgery, complications are expected to arise from time to time. One of the more important complications of OLT is post-transplant ascites.

Methods A retrospective review of medical records of 51 random patients who underwent liver transplantation at our institution over a 5-year period was undertaken. Data were collected on the presence of ascites post transplant, etiology of liver disease, and gender. The presence of abdominal fluid on ultrasonography or examination was considered as positive. Those with a lack of fluid or with trace amounts were considered to not have any ascites. We identified those patients who had alcohol as the sole cause of pretransplant liver disease. We then used Fisher's exact t-test to compare the presence and absence of pretransplant alcohol in those with and with out post-transplant ascites.

Results Fifty-one patients with OLT were identified, 37 of whom were men. Thirty-six of 51 were African American. Eighteen of 51 developed post-transplant ascites, and 8 required paracentesis at least once; the remainder were managed with diuretics. Alcohol was one of the indications for transplant in 14 patients and the sole reason in 3 patients. All 3 of these eventually developed post-transplant ascites. (p = .039) Additionally, these 3 were among the 8 who required paracentesis.

Conclusions Post-transplant ascites may develop secondarily to any number of causes, including technical problems such as biliary or lymphatic leaks, type of procedure, anastomotic issues, and recurrence of disease. However, it appears that in our review of 51 patients, in whom alcohol is the sole cause of liver disease, post-transplant ascites is more likely to occur. More studies are needed to corroborate our findings.

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