Organ Rejection

Your body’s normal response to your new liver is to try to destroy it as it is viewed as “foreign”. This process is called REJECTION. All transplant patients must take medications that prevent rejection. It is very important to take these drugs in the amount and time ordered by the transplant doctor. In this way, your body has a constant level of immnosuppressive drugs to prevent rejection.

In spite of taking these drugs as ordered, rejection will sometimes happen. Rejection occurs most frequently in the first few weeks after transplantation, but can happen at any time for the rest of your life. This is why you will be seen every week and have your blood work drawn twice a week for the first three months. Quite often, rejection can be detected from your blood tests before you start to fell any symptoms. When your :Liver function Tests” (LFT’s) rise, you will be asked to come to hospital to have a liver biopsy to confirm that rejection is happening. This is an important test since there are other causes for an increase in LFT’s, such as viral infections for which the treatment may be different than for rejection.

The usual initial treatment for rejection is intravenous steroids (solumedrol), and other drugs such as intravenous OKT3, may be needed for some episodes of rejection. Rarely, if rejection cannot be controlled, retransplantation is necessary.

As time passes after your transplant, the risk of rejection lessons. Through routine blood testing, biopsies and treatment, rejection can be controlled.

It is important that you are able to recognize the signs and symptoms of rejection. If you experience any of the following, you should notify your transplant doctor immediately:

Signs & Symptoms of Rejection:

• jaundice (yellow colour of skin and eyes)

• fever

• weight gain (greater than 2 lbs. in one day)

• swelling (ankles, hands and/or stomach)

• loss of appetite, nausea or vomiting

• abdominal pain or ache on right side

• fatigue

• itching

Remember:

1) Report any signs of rejection to your doctor immediately.
2) You must be alert for signs of rejection for the rest of your life.
3) You must take the immunosuppressive or “anti-rejection”  medications as ordered.
 

Infection

The drugs that you are taking to prevent rejection also decrease your body’s ability to fight infection. Therefore, you will be more prone to infection after transplantation. In addition, immunosuppressive drugs will mask some of the normal signs and symptoms of infection. It is for this reason, that we watch very closely for possible infection.

Antibiotics will treat most infections. However, it may be necessary to admit you to hospital for further treatment. Through routine monitoring, infection is diagnosed early.

Like rejection, infection is more common during the first weeks after transplant. It is important for you to know the signs of infection:

Signs & Symptoms of Infection:

• Fever (temperature greater than 37.5 C)

• Sore throat

• Shortness of breath

• Persistent cough

• Change in the colour of sputum

• Cold sores (around the lips and mouth)

• Pain or burning when you pass urine

• Redness, swelling, drainage or pain (around a cut/sore)

Remember:

1) Report any signs of infection to your doctor immediately.
2) Good nutrition, plenty or rest and a regular exercise program all promote a higher resistance to infection.
3) You must be alert for signs of infection for the rest of your life.