Liver Transplant Complications – The Risks Involved


Liver transplant complications are common, although the liver transplant surgery is a procedure that is performed on a day to day basis. Listed below are some of the complications that can arise either during or after the procedure.

Liver Transplant Complications – The Many Problems

Liver Transplant Complications #1 – Acute Liver Rejection

This is the most common complication that occurs in almost 40% of the cases in the first two weeks after the procedure. This generally happens when the newly donated liver is attacked by the body’s immune system as it recognizes the new liver as a foreign object. The symptoms associated with acute liver rejection include:

  • Fever (above 100.5 F or 38 degree Celsius)
  • Diarrhea
  • Vomiting
  • Jaundice
  • Dark urine
  • Pale stools
  • Itchy skin

In most cases, these symptoms can be managed by increasing the dose of corticosteroids the patient is on or by replacing the current calcineurin inhibitor with another. In this way acute transplant rejection can be managed successfully.

Liver Transplant Complications #2 – Infection

Infections are another serious worry as the slightest inconsistency can cause an infection of the liver. Calcineurin Inhibitors and corticosteroids are effective antibiotics which make the body’s immune system invulnerable to infections. The most common infections include:

Fungal Infections

Patients who have just had undergone a liver transplant procedure are generally affected by liver transplant problems like candidiasis and aspergillosis. The symptoms brought on by these infections vary generally based on which body part is affected by it. Some of the more common ones are:

  • Itchiness
  • Redness and scaling of the skin
  • A whitish thick fluid discharge from the vagina in case of vaginal infection

Fungal infections are more invasive and hence more serious. These generally attack your bloodstream and lungs (fungal pneumonia). The symptoms associated with these include:

  • Dizziness
  • Shortness of breath
  • Chest pain
  • High temperatures
  • Disorientation and confusion

Minor infections may also get worse if the patient is taking an immunosuppressant. In case any of the below mentioned symptoms persist; it is recommended that you call the transplant team.

Antifungal creams and other tablets can handle non-invasive fungal infections, but in case of invasive infections it is better to get admitted to a hospital where the doctors or the transplant team can begin treatment through a course of antifungal injections.

Antifungal injections are meant to fight off any fungal infections. The injections are administered for months after the transplant. Listed below are a few side effects of Fluconazole, a common antifungal medication.

  • Nausea
  • Indigestion
  • Flatulence
  • Headache
  • Diarrhea
  • Skin rash

CMV Infection (Cytomegalovirus)

The symptoms of Cytomegalovirus include:

  • Shortness of breath
  • Appetite loss
  • Occurrence of ulcers in mouth and stomach
  • High temperature
  • Pain in the joints
  • Visual problems like blind spots

In case you have any doubts regarding a CMV infection, contact a general physician or the transplant unit.

Liver Transplant Complications #3 – Diabetes

Diabetes (type II) is a serious and common complication that affects one out of five people after a liver transplant. Symptoms include:

  • Excessive urination
  • Excessive thirst
  • Feeling very tired
  • Loss of weight
liver transplant complications
Diabetes is one of the main liver transplant complications

Liver Transplant Complications #4 – Kidney Failure

Yet another one among the common liver transplant risks is kidney failure. It may occur within the timeframe of three to five years after the procedure. Under kidney failure, the kidneys lose their ability to filter waste from the blood. Symptoms of kidney failure include:

  • Blood in urine
  • Swollen hands, feet or ankles
  • Fatigue
  • Nausea
  • Shortness of breath

Liver Transplant Complications #5 – Graft Failure

Graft failure is a serious concern for patients undergoing liver transplants as it can affect at least one person in every 14. Under graft failure, the transplanted liver does not function correctly. Its symptoms include:

  • Reduced urine output
  • Seizures
  • Low consciousness levels
  • Muscle spasms
  • Double vision
  • Coma (worst case)

The only cure for this is to transplant a new liver.

Liver Transplant Complications #6 – Post Transplant Lympho Proliferative Disorder

It is a rather rare condition and occurs in one out of 50 people. The symptoms are:

  • Swelling of the lymph nodes
  • Pain in the abdomen
  • Loss of weight
  • High temperature
  • Difficulty in breathing because of swollen tonsils
  • Diarrhea
  • Night sweats

Liver Transplant Complications #7 – Cancer

There is an increased risk of developing cancer among patients who have a transplanted liver. The different types of cancer that can be contracted include:

  • Lymphoma
  • Cervical Cancer
  • Skin Cancer
  • Kaposi’s Sarcoma (cancer that is underneath the skin)
liver transplant complications risks
Patients are prone to liver transplant complications like cancer

A recent multicenter Belgian survey showed that there has been a reduction of almost 60% in the number of complications arising after or during a liver transplant in the last five years. This is definitely heartening information, as the surgical procedure is growing safer by the day.

Although the procedure has several complications, those affected by catastrophic liver damage don’t have a choice and should not be discouraged by these liver transplant complications. Surgical teams today perform operations carefully and every precaution is taken to ensure that the occurrence of these complications is avoided. Patients are also informed of the post liver transplant complications and are informed of other patient’s positive liver transplant stories to help them make informed choices.