Diagnosis and treatment of resistant ascites in liver recipients in the early post-transplant period

Introduction. Resistant ascites after liver transplantation is a relatively rare complication. At the same time, its presence significantly affects the prognosis and quality of life. Early diagnosis and successful treatment of resistant ascites can improve the long-term outcome. However, the aetiology of post-transplant ascites is heterogeneous, and the identification of the aetiological factor and the choice of treatment method in most cases is a significant problem for clinicians.

Objective. To present the review on methods of diagnosis and treatment of resistant ascites in liver recipients in the early posttransplant period.

Material and methods. The authors have reviewed the publications covering the main causes of ascites development after liver transplantation, the efficiency of instrumental diagnostic methods and surgical interventions in liver recipients with resistant ascites. The article has also discussed the authors' own observations of severe clinical cases of posttransplant ascites.

Conclusions. The preoperative status of the patient, the characteristics of the donor organ and the peculiarities of the surgical intervention should be taken into account in diagnosing the post-transplant ascites aetiology. In the absence of obvious predisposing factors, the patient should be evaluated sequentially to exclude vascular, intrahepatic and extrahepatic causes of ascites. The understanding of the main mechanisms of post-transplant ascites development and a consistent patient evaluation may help clinicians in choosing the treatment method.

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