Two Unusual but Treatable Causes of Refractory Ascites After Liver Transplantation


Refractory ascites (RA) is thought to complicate the postoperative course of 5–7 % (Nishida et al. in Am J Transplant. 6: 140–149, 2006; Gotthardt et al. in Ann Transplant. 18: 378–383, 2013) of liver transplant recipients. RA after liver transplantation is often a frustrating diagnostic dilemma with few good management options unless an obvious mechanical factor is identified. Supportive therapies often fail until a treatable precipitating cause is identified and removed. We describe two patients who developed RA following liver transplantation for primary sclerosing cholangitis, and hepatitis C and alcoholic liver disease, respectively. The cause for RA was hyperkinetic portal hypertension secondary to splenomegaly in the first case and a pancreatic AVM in the 2nd case. After failure of other interventions, surgical splenectomy resulted in immediate and durable resolution of the previously intractable ascites.

DOI: 10.1007/s00270-015-1120-5

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@article{Novelli2015TwoUB, title={Two Unusual but Treatable Causes of Refractory Ascites After Liver Transplantation}, author={Paula M. Novelli and Julia Shields and Veny Krishnamurthy and Kil-Ho Cho}, journal={CardioVascular and Interventional Radiology}, year={2015}, volume={38}, pages={1663-1669} }