Hepatic artery-duodenal fistula with gastrointestinal bleeding after liver transplantation

Gastrointestinal bleeding caused by peptic ulcer or portal hypertension is a serious complication in liver transplant recipients. However, Gastrointestinal bleeding from hepatic artery origin after liver transplantation is rare. We report duodenal massive bleeding secondary to erosion of hepatic artery after liver transplantation in two patients. This was diagnosed by angiography and treated subsequently by surgical intervention with hepatic artery re-anastomosis. We could not salvage one of these patients who died of complications of graft failure. Therefore, early diagnosis and aggressive surgical intervention may be required in order to salvage both recipient and graft.