Background : Living donor liver transplant (LDLT) is the mainstay for the management of end-stage liver disease. Surgical advances have led to good results however post liver transplant vascular complications remain a significant concern. Among these, post-surgery hemorrhage can lead to significant morbidity & mortality. We would like to show our experience of some of these cases and their surgical management.

Methods : Data was collected from a prospectively maintained database of 120 liver transplant procedures conducted between January 2021- December 2024. Total of 8 patients (6.6%) required re-exploration of these 5 (4.2%) were due to post liver transplant hemorrhage.

Results : The median age was 39 (34-55) years, the median MELD score was 22 (20-33), and all patients were of chronic liver disease except one had acute on chronic liver failure. Of the 5 patients, one had a periportal hematoma compressing the portal vein; which was treated by evacuating the hematoma, one had arterial anastomotic bleeding and one had hilar bleeding; both managed with reinforcing sutures, two patients did not show any obvious bleeding sources; managed with peritoneal lavage and drainage.

Conclusions : Early identification & re-exploration can improve the results in post-liver transplant hemorrhage.