Introduction: In this study, we examined the incidence and management of postoperative abdominal bleeding after orthotopic liver transplantation (OLT) and to identify risk factors for abdominal bleeding.

Materials and Methods: We retrospectively reviewed the medical records of 335 patients who underwent OLT at our institution from September 2001 to December 2012 to identify subjects with posttransplantation abdominal bleeding, defined as any hemorrhage requiring laparotomy within the first month.

Results: 42 (13,5%) patients showed abdominal bleeding, requiring laparotomy within the first month, occurring at a mean of 4,9 days (range, day 1 to 21 days). 11(23,8%) of them were cadaveric LT and 32(76,2%) of them were living related LT. The 26(62%) patients were male and 16(38%) patients were female. The bleeding sites requiring laparotomy were the inferior vena cava (n=12), liver graft cut surface (n=9), abdominal wall (n=5), greater omentum (n=5), hepatic artery (n=3) diaphragm (n=2), , portal vein anastomosis site (n=2), hilar plate (n=3) and abdominal drain insertion site (n=1), İn all patients, active bleeding was controlled with surgical ligation or vascular reconstruction. No patients passed away due to abdominal bleeding.

Conclusions: The risk of bleeding because of coagulopathy, anticoagulant treatement and iatrogenic injury is high during the early posttransplantation period. This can be minimized by meticulous surgical dissection and bleeding control. Also it is important to differentiate the patients who need a surgical intervation and who can be followed by medical treatments.