Ultrasonography after adult living donor liver transplantation: a review of vascular and biliary complications.

Living donor liver transplantation expands access to transplantation but introduces vascular and biliary reconstructions that require specific ultrasound assessment. Ultrasonography provides repeatable bedside evaluation without ionizing radiation, allowing early recognition of impaired flow and comparison with the postoperative baseline. This review examines how graft type and reconstruction affect Doppler interpretation in adult recipients, particularly after modified right-lobe transplantation. It addresses arterial, portal venous, hepatic venous, and biliary complications, with attention to measurement technique, transient postoperative changes, and limitations of diagnostic thresholds. Contrast-enhanced ultrasonography helps resolve uncertain arterial patency and perfusion. Computed tomography, magnetic resonance cholangiopancreatography, and invasive studies are selected according to the suspected complication and need for treatment.