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The risk of rejection is highest in the first 6 months after a transplant. After this time, your body's immune system is less likely to recognise the liver as coming from another person.
How can I prevent organ rejection? To help keep your body from rejecting the new liver, you will need to take medicines called immunosuppressants. These medicines prevent and treat organ rejection by reducing your immune system's response to your new liver. You may have to take two or more immunosuppressants.
The most common early symptoms include a fever greater than 100° F or 38° C, increased liver function tests, yellowing of the eyes or skin, and fatigue. Additionally, your doctor may want you to have a liver biopsy to confirm that your symptoms are caused by rejection.
Rejection occurs when your body's immune system begins attacking the new liver. In most cases it can be reversed if detected early. That's why it is important for you to be on the lookout for signs of rejection, including fever, yellowing of the eyes and skin, and fatigue.
Patients with untreated alcohol or other substance abuse disorders or untreated psychiatric illnesses are not eligible for transplantation. Patients who meet all of these requirements may sometimes be too sick or even too well for a liver transplant and are not placed on the waiting list.
Excessive brain swelling, or severe infection are signs that a patient may not be able to withstand a liver transplant.
Graft failure
It's one of the most serious complications of a liver transplant and occurs in around 1 in every 10 people. The most common cause is a disruption to the blood supply to the transplanted liver, caused by blood clots (thrombosis). Graft failure can develop suddenly, or slowly over a longer period of time.
Liver transplant survival rates
In general, about 75% of people who undergo liver transplant live for at least five years. That means that for every 100 people who receive a liver transplant for any reason, about 75 will live for five years and 25 will die within five years.
Although mortality has traditionally been estimated at 1 in 250 for living donation, a more recent survey found a 1 in 1,000 chance of death among liver donors at experienced centers, and a morbidity rate of approximately 30%.
After an organ transplant, you will need to take immunosuppressant (anti-rejection) drugs. These drugs help prevent your immune system from attacking ("rejecting") the donor organ. Typically, they must be taken for the lifetime of your transplanted organ.
Advancing age, sarcopenia, acute on chronic liver failure, and non-liver-related medical co-morbidities are common conditions that arise while on the wait-list that can render a patient too sick for transplant.
The chance to be transplanted at two years from listing was 65% and the risk of death was 17%. Patients with metabolic liver disease had the highest chance of undergoing liver transplantation.
In the U.S., a widespread practice requires patients with alcoholic liver disease to complete a period of sobriety before they can get on the waiting list for a liver. This informal policy, often called “the 6-month rule,” can be traced to the 1980s.
Never will race, ethnicity, religion, national origin, gender or sexual orientation have any part in deciding if you are a transplant candidate. You may be disqualified from having a liver transplant if you have: Current alcohol or drug abuse problems. Uncontrolled infection that will not go away with a transplant.
Acute rejection happens when your body's immune system treats the new organ like a foreign object and attacks it. We treat this by reducing your immune system's response with medication. Chronic rejection can become a long-term problem. Complex conditions can make rejection difficult to treat.
Living Donor Liver Transplantation
Posttransplant patient survival has been satisfactory: 91% at 5 years. In adult recipients the primary indications have been HCC and ALF, situations where the risk of delisting or death on the waiting list are significant.
Acute cellular rejection occurs in 25-50% of all liver transplant recipients within the first year after transplantation with the highest risk period within the first four to six weeks of transplantation. Once the diagnosis is made, treatment is fairly straightforward and generally very effective.
Heavy immunosuppression with tacrolimus, mycophenolate mofetil, and/or sirolimus may reverse chronic rejection in the early phases. Advanced chronic rejection is an indication for retransplantation.
"Flu-like" symptoms: chills, aches, headache, dizziness, nausea and/or vomiting. New pain or tenderness around the kidney. Fluid retention (swelling) Sudden weight gain greater than two to four pounds within a 24-hour period.