Aim: Central nervous system complications are an important cause of morbidity and mortality in transplant recipients. 
However, cerebrovascular complications (CVC) after living donor liver transplantation (LDLT) have seldom been 
reported. 
Methods: Between June 1990 and December 2007, 1297 patients underwent LDLT at Kyoto University Hospital. A 
retrospective review of all patients who developed CVC after LDLT was performed. 
Results: Of 1297 patients who received living donor liver transplantation (LDLT) at Kyoto University Hospital between 
June 1990 and December 2007, 14 (1.1%) developed CVC, including 11 with intracerebral hemorrhage and 3 with cerebral 
infarction. The onset of intracerebral hemorrhage was within 60 days (range, 1 to 58 days; median, 7 days) after LDLT. 
Twelve of fourteen patients died from CVC, for a mortality rate of 85.7%. Two patients had aspergillosis. Four cases had 
undergone retransplantation, and three patients had fulminant hepatic failure. Craniotomy with hematoma evacuation 
was performed in one patient. 
Conclusion: Though CVC is not a very common post-transplant complication, it carries a poor prognosis, as it occurs 
mostly in critically ill and complicated cases. Therefore, every effort should be made to prevent CVC.