Although rare, pyogenic liver abscess es following liver transplant ation can be chal­lenging to manage, with many of these occur in the setting of vascular compromise to the liver graft. Hepatic artery thrombosis is almost always the cause and is often associated with biliary tree necrosis and/or biliary stricture s [ 23 ]. Management of these abscesses can be challenging since with a compromised blood supply, the infection is very diffi cult to clear. In addition, clinicians are often faced managing these patients in the setting of chronic immunosuppression. Tachopoulou et al . reviewed their experience at the Cleveland Clinic from 1990 to 2000 in solid organ transplant patients and identifi ed 12 patients, all liver transplant recipients, with hepatic abscesses [ 24 ]. Thirteen patients underwent aspiration of the abscess from which 30 microbial isolates were obtained. Of these, 15 were gram-positive aerobic bacteria, 9 were gram-negative aerobic bacteria, and 3 were anaerobic. All patients except one were initially treated with percutaneous intervention. The overall mor­tality of the infected patients in this series was 36 %, signifi cantly higher then that reported for non-transplant patients. Five patients required retransplantation. Similarly, Nikeghbalian reviewed their experience and identifi ed 5 patients out of 560 liver transplant recipients with a hepatic abscess. Overall mortality in their series was 40 % [ 25 ].