What happens if rejection occurs after a liver transplant?

Rejection, the most common post-transplant complication, is the normal reaction of the body to a foreign object. When a new liver is placed in a person's body, the body sees the transplanted organ as a threat and tries to attack it. The immune system makes antibodies to try to kill the new organ, not realizing that the transplanted liver is beneficial. To allow the organ to successfully live in a new body, medications must be given to “trick” the immune system into accepting the transplant and not thinking it is a foreign object.

The first episode of rejection usually occurs about seven to ten days after transplant, but can happen months later. The classic signs include:

• fever greater than 100 degree
• jaundice (yellowing of the skin and eyes)
• dark urine
• itching
• abdominal swelling or tenderness
• fatigue
• irritability
• headache
• nausea

The doses of anti-rejection medications may change frequently, depending upon your response. Because anti-rejection medications affect the immune system, individuals who receive a transplant will be at higher risk for infections. A balance must be maintained between preventing rejection and making you very susceptible to infection. Blood tests to measure the amount of medication in the body are done periodically to make sure you do not get too much or too little of the medications. White blood cells are also an important indicator of how much medication you may need.

The symptoms of rejection may resemble other medical conditions or problems. Consult your transplant team with any concerns you have.