Department of Transplantation Dept. of Transplantation

16. Possible Complications

The period immediately following surgery has the potential of having complications ranging from mild to severe. Our team will monitor you closely to confront these issues as they come up. As your liver heals, the possibility for complications decreases as well, so you’ll need less monitoring as time goes by. The possible complications are listed below.

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Rejection

Rejection means that your immune system has identified the new liver as a foreign object, and is trying to attack it to get rid of it. If our team suspects a rejection, they’ll take a liver biopsy and inspect the tissue with a microscope. If they notice tissue deterioration, the rejection will be confirmed. In this case your anti-rejection medication (immunosuppressants) will need to be increased, and steroids will be administered to subdue your immune system. This occurrence is very common, and usually happens within 3 months post-surgery. To learn more, read our section on Anti-Rejection Medications.

Symptoms of Rejection: A fever over 100.5, or flu-like symptoms.

Infection

The downside of taking anti-rejection medications is that it pacifies your immune system, which leaves you vulnerable to infections from viruses, fungi, or bacteria. To prevent this from happening, you’ll need to take antibacterial, antivirus, and antifungal medications for 3 to 6 months after surgery. The main symptom to look out for is a fever. Contact the transplant team immediately if you get a high fever after you’ve been discharged from the hospital.

Follow these rules to avoid a serious infection:

  • Stay away from sick people
  • Wash hands with soap before eating and after using the bathroom
  • Shower regularly, and wash the area of the incision as you would any other part of your body
  • Clean cuts and scrapes with soap. Apply an antiseptic and a bandage.
  • Never touch feces from pets without gloves, and make sure you wash your hands thoroughly after doing so.
  • Always wear gloves while gardening or touching dirt.
  • Brush and floss your teeth every day.
  • Keep nails clean and trimmed.
  • Do not get any vaccine that contains a live virus (such as smallpox or polio vaccine). Talk to the transplant team before getting any vaccination, or if someone you live with is getting
    • vaccinated.
  • Do not smoke, and avoid second-hand smoke at all costs.
  • Do not consume alcohol.
  • Consult with our transplant team if you’re planning on traveling outside of the country so we may assess any risks and give you recommendations.

Symptoms of Infection: fever, chills, fatigue, diarrhea, vomiting, redness or drainage around the incision site, and a cough or sore throat.

Bleeding

1 in 10 liver transplant recipients experience bleeding after surgery. When this happens, a second surgery will be necessary to find the source and correct it. Symptoms to look out for are: bleeding from the incision, throwing up blood, and blood in bowel movements. Contact us immediately if you suspect you are bleeding.

Other

Rarer complications include:

  • Liver graft nonfunction: the transplanted liver simply does not perform as expected, in which case a new liver transplant will be required immediately.
  • Renal Dysfunction: Kidney function drops substantially as a consequence of the stresses of transplant surgery. This complication is usually temporary and reversible.
  • Bile duct complication: The connections made on your bile ducts may leak or become blocked. Sometimes this can be corrected externally, but may sometimes need to be reversed through a second operation.