Abstract:

BACKGROUND: Upper gastrointestinal bleeding (UGIB) is one of the more common complications in liver transplantation, the incidence of reported abroad was up to 8.9% and of reported domestic was 5%.
OBJECTIVE: To investigate the causes and treatment methods of UGIB after adult orthotopic liver transplantation.
METHODS: Totally 412 patients with UGIB after orthotopic liver transplantation was retrospectively reviewed. The bleeding causes and effect of hemostatic process on patient and grafts survival were analyzed.
RESULTS AND CONCLUSION: Totally 16 cases were subjected to UGIB during the first postoperative two months, including 8 cases with gastroduodenal ulcers bleeding, 4 cases with gastric fundus and esophagus variceal bleeding, 4 cases with hemobilia and 4 cases were dead. Bleeding inducements included that application of high-dose corticosteroids in acute rejection, serious infections, biliary fistula, hepatic artery pseudoaneurysm formation, percutaneous transhepatic biliary drainage, liver biopsy and so on. Eight cases underwent successful hemostasis by medical treatment, three cases underwent successful intervention treatment and one case underwent successful hemostasis by laparotomy. Peptic ulcers is the most common causes of UGIB following orthotopic liver transplantation, variceal bleeding and hemobilia are the second. After definite diagnosis, reasonable treatment should be immediately received, and active preventive measures should be also given to the patients according to the situation before transplantation.