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Liver Transplantation

What Complications Are Associated With Liver Transplant?

Two of the most common complications following liver transplant are rejection and infection.

Rejection:

Your immune system works to destroy foreign substances that invade the body. But the immune system can't distinguish between your transplanted liver and unwanted invaders, such as viruses and bacteria. So, your immune system may attempt to attack and destroy your new liver. This is called a rejection episode. About 65% of all liver-transplant patients have some degree of organ rejection, most within the first 6 weeks of transplant. Anti-rejection medications are given to ward off the immune attack.

Infection:

Because anti-rejection drugs that suppress your immune system are needed to prevent the liver from being rejected, you are at higher risk for infections. This problem lessens as time passes. Not all patients have problems with infections, and most infections can be treated successfully as they happen.

 

What Are Anti-rejection Medications?

After the liver transplant, you will receive medications called immunosuppressants. These drugs slow or suppress your immune system to prevent it from rejecting the new liver. They may include azathioprine (Imuran), mycophenolate mofetil (CellCept), prednisone (  Medrol,  Prelone, Sterapred DS), cyclosporine (Neoral), tacrolimus, (Prograf),  sirolimus (Rapamune) and everolimus (Afinitor, Zortress). You must take these drugs exactly as prescribed for the rest of your life.

When Will I Be Able to Go Home After a Liver Transplant?

The average hospital stay after a liver transplant is 2 weeks to 3 weeks. Some patients may be discharged in less time, while others may be in the hospital much longer, depending on any complications that may arise. You need to be prepared for both possibilities.

To provide a smooth transition from hospital to home, the nursing staff and your transplant coordinator will begin to prepare you for discharge shortly after you are transferred from the intensive-care unit to the regular nursing floor. You will be given a discharge manual, which reviews much of what you will need to know before you go home.

You will learn how to take new medications and how to monitor your own blood pressure and pulse. As you do these things regularly, you will become a participant in your own health care. Before your discharge, you will also learn the signs of rejection and infection, and will know when it's important to call your doctor.

Readmission after discharge is common, especially within the first year after a transplant. The admission is usually for treatment of a rejection episode or infection.

What Follow-Up Is Necessary After a Liver Transplant?

Your first return appointment after a liver transplant will generally be scheduled about 1 to 2 weeks after discharge. During this visit, you will see the transplant surgeon and transplant coordinator. If needed, a social worker or a member of the psychiatric team may also be available.

All patients return to their transplant hospital approximately 5 months after the transplant. If a T-tube was inserted during the operation, it will be removed by the transplant surgeon at this time.

All patients are scheduled to return to the hospital at their 1-year transplant anniversary date and annually thereafter.

Your primary care doctor should be notified when you receive your transplant and when you are discharged. Though most problems related to the transplant will need to be taken care of at the transplant hospital, your primary care doctor will remain an important part of your medical care.

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WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on April 15, 2013

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