Dr Priya Sharma Healthcare Professional
A liver transplant is an effective procedure for patients suffering from acute or chronic end-stage liver disease.
A liver transplant surgery is a complex procedure that has a high morbidity-mortality rate. The procedure is associated with several complications after surgery.
Most liver transplant operations are associated with the risk of developing complications after the procedure. Most of these complications are minor, however, rarely some complications could be life-threatening. Treatment of these complications in the early stages is very important.
In this article, we will discuss the immediate, as well as long-term post-operation complications of a liver transplant.

Post-operation complications of liver transplant:
A liver transplant may be associated with several complications, some of them may develop immediately after the surgery and some complications may develop some time after a liver transplant surgery.
Immediate post-operation complications of liver transplant:
The short-term or immediate complications of liver transplant are:
Technical complications: Thrombosis or blood clot formation in the hepatic artery (a blood vessel that supplies blood to the liver) is one of the most common and frequent types of complication seen after a liver transplant surgery.

Blockage of blood supply to the new liver: The blood clot may block a part of the blood supply to the new liver and stop it from functioning properly. If this occurs, there could be a need for more surgery or drugs for blood thinning. If there is damage to the new liver, another liver transplant may be needed.

Medical complications: Sometimes, a patient may experience complications once there is a gradual improvement in liver activities. In such cases, the patient may need an extensive stay in the intensive care unit (ICU), and the possibility of mortality increases. The most common medical complications that can develop after a liver transplant are kidney problems, neurological complications, respiratory problems, and hemodynamic changes.

Bleeding: It is common to have mild bleeding for up to 48 hours following a liver transplant surgery. This is because the liver usually controls blood clotting.

Infections: It is a major short-term type of complication that may occur after a liver transplant. Immunosuppressant medications, also known as anti-rejection drugs, are used to suppress the body’s immune system or disease-fighting system to prevent the body from rejecting the new liver. But these medicines increase the risk of developing infections. Most of these infections can be managed if treated early on.

Bile leakage: Bile is a fluid that helps in the digestion of food by breaking down fat. The liver makes bile that is stored in the gallbladder. Small tubes known as bile ducts carry this bile and connect the gallbladder and liver to the small bowel. There is a risk of bile leakage from the joint between the bile ducts.

Rejection: If immunosuppressant medicines are not given, the newly transplanted liver could be rejected by the body’s immune system. This may happen because the body’s immune system fails to differentiate between the transplanted liver and the unwanted bacteria and viruses. This is why anti-rejection medications are prescribed to decrease the risk of rejection. Most cases of rejection occur within one or two weeks of a liver transplant surgery. This is known as acute rejection.

Liver graft dysfunction: An early liver graft dysfunction may occur due to the following reasons:
Problems with the graft itself, which may include liver rejection, non-specific cholestatic syndrome, and malfunction or dysfunction.
Problems due to the surgical technique used, including arterial or vascular, poor drainage of the suprahepatic veins, and biliary portal thrombosis.
Drug-related liver toxicity and infections could also lead to graft dysfunction.
Long-term complications of liver transplant:
Long-term complications following a liver transplant are generally related to immunosuppressive treatment. These complications usually develop after a few years of the surgery and could include chronic kidney failure, dyslipidemia, diabetes mellitus, obesity, bone or neurological complications, systemic arterial hypertension, and the development of de novo tumors.
Chronic rejection: This type of rejection is usually evident only after at least 6 months of a liver transplant surgery. Although the exact cause is not known, there is still a possibility of the body rejecting the liver.

Renal failure: Chronic renal failure following a liver transplant is closely related to the use of calcineurin inhibitors. Depending on the criteria used for defining it and the method for assessing the renal function, the prevalence of the complication is variable.
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Apr 15th 2023 02:04