A Novel Use of an Arterial Catheter for Extended Peripheral Venous Access in Postoperative Liver Transplant Recipients: A Case Series

Background: Securing reliable intravenous access in postoperative liver transplant recipients is often challenging due to oedema, coagulopathy, vasodilation, and prior cannulations. Central venous catheters (CVCs) provide dependable access but are associated with infectious and thrombotic complications. We describe our experience using a standard arterial catheter as an extended peripheral venous access device under ultrasound guidance. Case Series: Fifteen adult patients undergoing orthotopic liver transplantation with difficult peripheral access received ultrasound-guided placement of a 20-G arterial catheter (Leadercath, Vygon, UK) into the basilic or brachial vein using the Seldinger technique. Catheter dwell time, functionality, and complications were observed. Results: Successful placement was achieved in all patients on the first attempt. Mean dwell time was 7.2 ± 1.4 days (range 5-9 days). No catheter-related bloodstream infection, thrombophlebitis, infiltration, or premature failure occurred. None required additional central venous access. Conclusion: Ultrasound-guided use of an arterial catheter as an extended peripheral venous line appears to be a safe, practical, and cost-effective alternative in postoperative liver transplant recipients with difficult venous access.