Ascites after Liver Transplantation.

Ascites is a clinical complication of cirrhosis that occurs due to hemodynamic changes that result in circulatory malfunction, causing systemic and splenic vasodilation as a result of increased nitric oxide. The presence of persistent ascites pretransplant is associated with poor survival, and thus these patients are best served by transplant. Following orthotopic liver transplant (OLT), ascites is expected to resolve within 2 to 4 weeks as reversal of previous systemic derangements occurs. Persistent ascites, defined as ascites more than 4 weeks after successful OLT, is a rare occurrence but has been described to occur in 3% to 7% of patients. 5 Patients with persistent ascites after transplant have increased morbidity and decreased 1year survival. 5