Nearly 6,300 people received liver transplants in the United States between July 2008 and June 2009, according to UNOS, the United Network for Organ Sharing. Of those, UNOS statistics indicate that 88.6 percent survived one year after transplant, and 78 percent were still alive three years after transplant. Complications two years after liver transplant range from mild and easily treated to potentially life threatening. Complications can occur from the anti-rejection medications taken after transplant or from the procedure itself.
Bile Duct Complications
After removal of the old liver, the new liver is connected to the blood vessels and ductwork that allows it to function. Scarring and strictures, or narrowing of the blood vessels, can occur within the bile ducts that connect to the liver and can threaten survival of the new liver. Leakage at the site of connection can also occur. Biliary tract complications affect less than 4 percent of patients per year after transplant, reports Luis Marsano, M.D., Director of Hepatology at the University of Louisville.
Infection
Infection, the most common cause of death after liver transplant, according to Dr. Marsano, affect two-thirds of patients within the first year after transplant, but can occur at any time. Infection develops as a result of oversuppression of the immune system with anti-rejection medications. Bacteria, viruses, fungi and parasites can all cause serious infections in liver transplant patients at two years’ post transplant and beyond.
Rejection
According to UNOS statistics, around 12 percent of liver transplant patients experience graft failure between one and three years after transplant. Rejection of the new liver, one reason for liver failure, can occur any time after transplant, the Ohio State University Medical Center reports. Symptoms include fever, jaundice, flu-like symptoms, fatigue and pain or tenderness over the liver. Biopsy, removal of a piece of the liver and analysis of the cells under microscope, shows cellular changes that indicate rejection.
Rejection occurs when a person’s immune system attacks the donated organ because it recognizes it as foreign. Medications taken after transplant suppress the immune system in an effort to prevent rejection. Treatment involves increasing the doses of anti-rejection medications and may require hospitalization to prevent loss of the organ and a need for another new organ.
Anti-Rejection Medication Complications
Anti-rejection medications can cause significant problems at any time after liver transplant including after two years. Complications of anti-rejection medications include bone loss, diabetes, high blood pressure and increased cholesterol levels, MayoClinic.com states. Most medications complications can be treated with preventative medication. Immunosuppressive medications also increase the risk of developing cancer several years after transplant, the University of Illinois Medical Center warns, with skin cancer and lymphoma being the most common.
