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Transplant Rejection of Liver

Last updated Dec. 24, 2018

Approved by: Maulik P. Purohit MD MPH

Transplant Rejection of Liver occurs when the immune system of the recipient recognizes the new liver as being foreign and thus, harmful to the body. In other words, the body recognizes the donor liver tissue as foreign and reacts against it.


What are the other Names for the Condition? (Also known as/Synonyms)

  • Graft Rejection of Liver
  • Hepatic Graft Rejection
  • Tissue/Organ Rejection - Liver

What is Transplant Rejection of Liver? (Definition/Background Information)

  • Liver transplantation is a procedure to surgically remove a damaged or diseased liver and replace it with a healthy liver, from a compatible donor. A donor liver can either come from a deceased organ donor or from a live organ donor
  • Transplant Rejection of Liver occurs when the immune system of the recipient recognizes the new liver as being foreign and thus, harmful to the body. In other words, the body recognizes the donor liver tissue as foreign and reacts against it
  • Every individual has an immune system that ensures that no foreign particle or material enters the body. Sometimes, when there is an entry of a foreign substance, the body automatically starts to react or fight against the substance, in order to eliminate it from the body
  • The immune cells attack the foreign object, in this case, the donor liver, in an attempt to destroy it, if they do not recognize the antigens of the newly transplanted liver
  • Antigens are foreign entities that get introduced in the body, against which antibodies are produced to render them harmless. Hence the need for matching the ‘donor’ to the ‘recipient’ as immunologically close as possible, by using tissue-typing techniques
  • Some risk factors for Transplant Rejection of Liver include a prior history of organ rejection, certain medications, infection in the liver, or abnormalities in the donated liver
  • Due to Graft Rejection of Liver, there may be fever, jaundice, formation of dark urine, abdominal pain and swelling, and a general feeling of illness. The condition is diagnosed through a physical exam, laboratory tests for liver function, and a liver biopsy
  • Generally, the condition is treated using immunosuppressive medications. The prognosis of Transplant Rejection of Liver is satisfactory, with current advances in treatment
  • However, if the signs and symptoms are severe and there is a delay in the diagnosis, the outcome may be poor

Who gets Transplant Rejection of Liver? (Age & Sex Distribution)

  • Any individual who receives a liver transplant can potentially reject it, irrespective of age and gender
  • Generally, individuals with weaker immune systems have a lower risk of graft rejection than those with stronger immunity

What are the Risk Factors for Transplant Rejection of Liver? (Predisposing Factors)

Risk factors associated with Transplant Rejection of Liver may include:

  • Infection of liver
  • Prior episodes of organ rejection
  • Certain medications
  • Non-compliance with therapy or not taking anti-rejection medication, as prescribed by the healthcare provider. Missing even one dose can significantly increase the risk
  • Unrecognized abnormalities in the donor liver
  • Age: The younger the age, the higher is the risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Transplant Rejection of Liver? (Etiology)

The causes for Transplant Rejection of Liver may include:

  • The donor organ being “mismatched” or not matching closely with the recipient’s body system
  • An adverse reaction that occurs when the body recognizes the new organ as being harmful
  • Presence of certain underlying conditions such as an infection or a chronic illness

What are the Signs and Symptoms of Transplant Rejection of Liver?

The signs and symptoms that might indicate a Transplant Rejection of Liver include:

  • Jaundice
  • Dark urine
  • Itching
  • Abdominal swelling or tenderness
  • Fever, discomfort or feeling ill
  • Body aches
  • Nausea
  • Cough, shortness of breath

How is Transplant Rejection of Liver Diagnosed?

The diagnosis of Transplant Rejection of Liver may involve the following exams:

  • Complete evaluation of medical history, along with a thorough physical examination
  • Diagnostic tests that include:
    • Complete blood count
    • Liver function test including transaminase and bilirubin levels
    • Ultrasound and CT scan of abdomen
    • Biopsy of liver tissue: A piece of tissue is taken and sent to the laboratory for examination by a pathologist under the microscope. The pathologist will look for possible microscopic changes that could be present in the rejected liver

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Transplant Rejection of Liver?

Some potential complications of Transplant Rejection of the Liver may include:

  • Infections, due to suppression of immune system by immunosuppressant medications
  • Decrease in liver function after transplant
  • Excessive bleeding, since the liver is responsible for producing proteins that control clotting

How is Transplant Rejection of Liver Treated?

  • Transplant Rejection of Liver is treated by administering immunosuppressive medications immediately after liver transplant, to suppress the individual’s immune system
  • Hospitalization may be necessary in severe cases, till the condition resolves

How can Transplant Rejection of Liver be Prevented?

Preventive measures for Transplant Rejection of Liver can include:

  • Tissue-typing of the recipient and donor: Ensuring that the donor and recipient are closely matched individuals - minimizing the chances of the recipient’s immune system recognizing the donor's antigens as foreign
  • Taking immunosuppressive medications as prescribed by the specialist or healthcare provider
  • Regular follow-ups with the healthcare professional or specialist to ensure that complications, if any, are addressed promptly and the graft is functioning properly
  • Identifying the issue in its early stages, so that it can be treated promptly and effectively

How is the Prognosis of Transplant Rejection of Liver? (Outcomes/Resolutions)

  • The prognosis of Transplant Rejection of Liver is reportedly satisfactory, owing to advances in modern medicine
  • However, if serious rejection occurs, which is not diagnosed and treated promptly, the outcome can be unfavorable

Additional and Relevant Useful Information for Transplant Rejection of Liver:

  • Liver transplantation is a procedure that involves the surgical removal of a damaged or diseased liver and replacement with a healthy liver, from a suitable and compatible donor

The following article link will help you understand liver transplant surgical procedure:

http://www.dovemed.com/common-procedures/procedures-surgical/liver-transplantation/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: April 28, 2016
Last updated: Dec. 24, 2018