Introduction: Living-Related Liver Transplantation (LRLT) was developedin 1989 to overcome the high mortality on the waiting list for patients withend stage liver disease. Since then, liver transplantation programs around theworld have begun to employ this method with encouraging results. Vascularcomplications, especially hepatic artery thrombosis, are the second leadingcause of graft failure in the immediate post-operative period and remain animportant cause of morbidity and mortality for transplant recipients.Aim of the study: To correlate the clinical, laboratory, sonographic and noncontrastDoppler findings in the hepatic graft vasculature in LRLTrecipients, in the post transplantation period, firstly in the detection of posttransplantation hepatic and portal vascular complications; their incidenceand severity, their impact on graft function and patient survival and theirimpact on the various medical parameters that influence the outcome of thetransplant procedure and secondarily in relating the various post transplantcomplications with the Doppler changes of the hepatic and portal vessels.The study enrolled hundred adult recipients Patients and methods: of livingrelated liver transplantation who underwent their surgery in Dar AL-FouadHospital over the period of four years. All recipients received a right hepaticlobe. The number of transplant surgeries were 102, because two out of thosehundred had a re-transplant. The study was carried out after the approval of theMedical and Ethical committees of the Tropical Medicine Department, CairoUniversity, and of Dar Al- Fouad Hospital.Results: Hepatic vascular problems were diagnosed in 15 recipients (15 %).Their total number was 17 (9 hepatic artery problems, 6 portal vein problemsand 2 hepatic venous outflow problems). Twelve (70.6 %) of the reportedvascular complications occurred within the first 4 weeks post transplantation(early complication), and the remaining 5 (29.4 %) occurred beyond 4 weekspost transplantation (delayed complication). There was no statisticalsignificance between the group who developed vascular complications andthe group who did not in the overall mortality rate, rate of acute cellularrejection (ACR), number of biliary problems, recurrence of HCV hepatitis,incidence of systemic or graft sepsis, number of chronic cellular rejectionepisodes (CCR), Child-Turcotte-Pugh (CTP) class and pre-operative modelfor end stage liver disease (MELD) score, presence of pre-transplanthepatocellular carcinoma (HCC), recipient or donor age, recipient sex, or the immune suppression regimen used. The Doppler ultrasound (DUS) findingsobtained from the hepatic artery (HA), portal vein (PV), hepatic veins (HV)and inferior vena cava (IVC) were also non diagnostic nor specific in thepatients who developed ACR, biliary problems, recurrent HCV hepatitis,systemic or graft sepsis or CCR.On the other hand, there was a statistically significant difference betweenthe two groups in the incidence of graft failure (33.3 % for those whodeveloped a vascular problem versus 4.7 % for those who did not) and in theduration of hospital stay post transplant (39.9 +- 30 days versus 28.5 +- 15days) respectively. The Doppler findings obtained from the HA, PV, HV andIVC were reliable to diagnose the various post transplantation problemsaffecting these vessels.Conclusion: Hepatic vascular complications following living related livertransplantation are still considered to be an important issue with aconsiderable incidence rate and an important cause for graft relatedproblems. They also do prolong the period of hospital stay posttransplantation. DUS is a reliable method in the diagnosis of hepatic andportal vascular problems occurring in the post transplantation setting but isless sensitive in the diagnosis and follow up of other medical or surgicalcomplications.