The transplant team may perform one or more of the following tests and procedures to monitor a patient's transplant:

• Ultrasound - This test is performed to make sure all the main blood vessels leading to the liver are functioning normally. This test is also used to check for collections of fluid, such as blood or bile. The procedure consists of placing a cool gel on the patient's abdomen, over which a wand (transducer) is moved to transmit sound waves. These are converted into images of the liver and projected onto a television screen.

• Percutaneous transhepatic cholangiogram (PTC) - This is an X ray that shows the patient's bile ducts to check for leaks, blockages, or other potential problems. The procedure starts with a dye injection into the T-tube. The dye makes the ducts easy to see on X ray. If a T-tube was not placed during your surgery, this X ray will be performed after dye has been injected directly into the liver-bile ducts.

• Liver biopsy (test sample) - This test is usually performed to check for rejection, hepatitis, or other possible problems. This may be done in the hospital or in the outpatient/short-stay unit. The patient will receive special instructions regarding the procedure. Before the procedure, the patient will receive a numbing injection (local anesthetic) on the right side of his abdomen. Then a special needle will be inserted to withdraw a small sample of liver tissue that will be examined with a microscope. After this procedure, the patient must lie on his right side for at least 1 hour and stay in bed for about 4 hours.

• Computerized tomography (CT) scan - This is a type of X ray that allows the physician to view the patient's liver from many different angles to detect infections, fluid collections, or other problems. The procedure requires that the patient drink a liquid that outlines his stomach and intestines and makes his liver more visible; then he lies flat for 1 hour while the machine takes X rays around him.

• Magnetic resonance imaging (MRI) - This is another type of test that produces an image. Somewhat like a CT scan, it also allows a patient's liver to be viewed from different angles and in three-dimensional images. An MRI shows soft tissues, such as the liver, more clearly than a CT scan does.

• Endoscopic retrograde cholangiopancreatogram (ERCP) - This test allows the physician to see the patient's biliary tree (the various ducts in and around the liver), as well as the ducts from the pancreas. The patient will be given medicine to relax him before the procedure. An endoscope (a type of tube) is placed in his mouth; it is advanced through to his stomach and into his intestine to the liver. A dye is then infected through the endoscope that makes the ducts visible in X rays.