Pediatric Liver Transplant

Complications after a Liver Transplant

A pediatric liver transplant can save a child’s life, but even when the surgery goes very well, complications can occur. Some of these complications can be addressed quickly, while others may require longer-term follow-up care. Our specialists have a great deal of experience in detecting problems early on and in providing effective treatment.

Potential Complications

Liver RejectionHide

After a liver transplant, the body recognizes the liver is not its own. Its natural reaction is to reject the new liver. Your child will take medication to help prevent a rejection. However, approximately 50 percent of patients experience some degree of liver rejection in the first year following transplant.

Your child’s physician will watch for signs of liver rejection by testing liver enzyme levels in your child’s blood on a regular basis. Elevated enzyme levels may be the only symptom of rejection. If your child’s physician suspects rejection, the liver care team will conduct a liver biopsy.

If the doctor determines that the body is rejecting the new liver, your child will probably be hospitalized for five to seven days. Usually, medications control rejection. The doctor may repeat the liver biopsy to ensure that the rejection has been controlled. In rare cases of severe and untreatable rejection, doctors may need to perform another liver transplant.

Infection after Liver TransplantationShow

Rejection medications help the body accept the new liver, but they make it harder for the body to fight infections. Infection is a threat to every transplant patient. The liver care team at Cincinnati Children's will prescribe many medications to help your child avoid infection. You can do your part by faithfully washing your hands every time you enter and leave your child's room and by ensuring that visitors do the same. Hand washing is the most effective way to prevent the spread of infection.

Kidney ProblemsShow

Some transplant patients experience kidney problems after surgery, but these problems usually are treatable. In rare instances, dialysis (which involves using an artificial kidney machine) is needed to filter the blood until the kidneys start working again.

Bile Duct ProblemsShow

The bile duct allows bile (fluid that aids in digestion) to move in and out of the liver. Some children have problems related to the bile duct after surgery. In some cases, patients need to have drains placed and tests performed to make sure the bile ducts are working properly.

Primary NonfunctionShow

When the liver segment is removed from the donor, it is placed in ice. Despite the care and precautions we take before the transplant, there are times when the new liver does not "wake-up" after surgery. This is called primary nonfunction. If this occurs, your child will need to be re-transplanted immediately. This is an exceedingly rare complication nowadays.

ThrombosisShow

Sometimes, a clot (thrombus) forms immediately after surgery in the hepatic artery or the portal vein (the vessels that supply blood to the liver). As a precaution, the liver care team will perform an ultrasound daily for the five days after transplant surgery. If the doctor detects a clot, the team will surgically remove it. If the clot is detected quickly, it usually can be removed from the artery or vein. If the clot cannot be removed, doctors may need to perform a re-transplant.

BleedingShow

Bleeding is a common complication in any operation. If your child experiences heavy bleeding after liver transplant surgery, the surgeon may need to perform an additional operation to control it.

Liver Transplant Medications

Learn more about the special medications available to help your child’s body accept a transplanted liver. Read more

Creative Surgery Idea Saves Teen's Life

Liver transplant recipient, Leah, is alive today thanks to Dr. Bryan Goldstein's creative idea for a stent that can "grow" the blood vessel to properly connect to her new liver.

Pediatric Liver Transplant

Complications after a Liver Transplant

Potential Complications

Liver Transplant Medications

Creative Surgery Idea Saves Teen's Life

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