Introduction: The overall incidence, etiology, and timing of posttransplantation gastrointestinal bleeding are described in a limited number of publications. They are rare but life-threatening conditions. In this study, we examined the causes and treatment of postoperative gastrointestinal bleeding after orthotopic liver transplantation (OLT).

Materials and Methods: Clinical data of 335 patients who underwent OLT at our institution from September 2001 to December 2012 were analyzed retrospectively. The experiences in diagnosis and treatment of postoperative gastrointestinal bleeding after OLT were reviewed.

Results: Gastrointestinal bleeding occurred in 13 patients (3.8%) after OLT. The 5(38,4%) patients were adult and 8(61,6%) patients were pediatric. The sites of the bleeding was; jejuno-jejunal anastomosis bleeding in 5 cases, peptic ulcer in 3 cases, erosive gastritis in 3 cases, gastric and esophageal varices in 1 case, and hemobilia in 1 case. These 13 patients with gastrointestinal bleeding were managed with conservative treatment, endoscopic treatment, radiological interventional embolism, or exploratory laparotomy. No patients passed away due to gastrointestinal bleeding. During the follow up period 5 patients passed away (Causes of death: n= 5 sepsis, n=1 reccurence of HCC).

Conclusions: Gastrointestinal bleeding after liver transplantation and its incidence, etiology, and timing are not well described in the literature. Bleeding may occur from different sites after OLT. Diagnosis and management of gastrointestinal bleeding requires a multidisciplinary team approach involving surgeons, hepatologists, advanced and experienced endoscopists and interventional radiologists.