After liver transplantation, the patient will gain better health, be able to perform daily activities as close to normal and take care of him/herself. He/she will have better mental health and better sexual ability. However, there are possible risks as follows:
- Complications of general anesthesia including nausea, vomiting, dizziness.
- Post-procedure hemorrhage may cause lower blood pressure which blood transfusion may be needed.
- Changes to the heart and cardiovascular system, such as heart failure, arrhythmia, and high blood pressure.
- Injury to abdominal organs, fluid accumulation, and fibrosis inside the abdominal cavity.
- Digestive problems, such as constipation or bloating.
- Pain or uncomfortable at the surgical site which may progress to chronic pain.
- Graft failure
Normally, a new liver should function immediately after transplantation. Sometimes, the new liver does not start to work right away because there is no blood flow to the liver. This may occur immediately or slowly. The signs are jaundice (yellow skin and eyes), ascites, and changes in consciousness. The doctor will give medications to reduce the symptoms, but the patient may undergo liver retransplantation.
Normally a transplant patient will begin taking anti-rejection medication before the surgery, while in surgery, and after the procedure, and thus an acute rejection of the transplanted liver is rare. It is very important that a transplant patient takes their immunosuppressive medication regularly and continuously as instructed by their doctor to prevent acute rejection. Chronic rejection is a slow rejection of the transplanted liver and may occur due to a number of factors. Unfortunately, it cannot be completely prevented, but the risk of rejection can be controlled by managing any existing conditions. The patient must continuously take immunosuppressive medication as prescribed by their doctor.
After the liver transplant the patient’s immunity will be compromised, making them prone to infections, such as pneumonia, or other opportunistic viruses like cytomegalovirus (CMV), herpes virus, Epstein-Barr virus (EBV), fungus, parasites, and tuberculosis. Patients may have to take medication to prevent infection for a while after surgery, depending on the decision of their doctor.
This is the most common complication found in 5-15% of patients with liver transplantation. Bile leakage can be healed by an endoscope with a plastic tube to release the bile in order to reduce the pressure or using a soft tube to transfer the bile to other areas to let the wound heal.
- Biliary atresia (a blockage of the bile ducts)
This is rare and can be treated by using endoscopic biliary stenting to dilate the blocked part of the bile duct.
- Other complications after long-term liver transplantation such as diabetes, hypertension, hyperlipidemia, and cancer mostly occur due to the effects of immunosuppressive medications used.
The quality of life of a patient who has suffered with end-stage chronic liver disease will dramatically improve after the transplant, but some patients may suffer emotional complications, such as depression and agitation. Furthermore, some patients are at risk for not strictly following the post-transplant regimen of immunosuppressive drugs, perhaps even causing them to lose the donor liver.