Liver is the largest organ in the body. It is an important organ having several functions to play. Liver failure can thus lead to death of a person. Irreversible end stage liver disease can lead to liver failure. The main cause of liver failure is hepatitis B and C, chronic alcoholism, cirrhosis and prolonged malnutrition.
Liver transplant is a surgical procedure in which the damaged liver is removed and is replaced with a healthy liver received from a donor. The compatible donor can be either deceased or living donor. Although liver transplant has good prognosis, transplant rejection still remains one of the major complications of liver transplant. Rejection occurs when the immune system of the recipient recognizes the new liver as foreign substance and reacts to it.
The symptoms of rejection are recognized as fever, dark yellow or orange urine, pain in abdomen, weakness and swelling of legs.
What Causes Liver Transplant Rejection?
Liver transplant rejection occurs when the immune system of the recipient attacks the donor liver as it recognizes it as a foreign substance. Every person has an immune system which helps in protecting the body against foreign material entering into it. On detecting the foreign substance the immune system of the body takes out its ammunition from the armament to fight off the foreign substance and eliminate it from the body.
When a person receives liver from someone, the antigens present in the cells of the donor liver are recognized by the immune system of the recipient as foreign harmful substance. The immune system perceives that they are different and not matched. The immune system of the recipient person releases antibodies to fight the antigens. Thus organ that does not match closely can trigger a transplant rejection. To prevent this, doctors match organ of donor and recipient before transplantation.
When the antigen from both the organs is similar it is less likely to cause transplant rejection. Tissue typing and matching is common process between the donor liver and recipient liver. Since no two persons are identical except twins, the match will not be usually completely perfect. Hence patient is given immunosuppressive medicines so that the immune system of the recipient will not attack the newly transplanted liver. The risk factor increases infection in liver, if there is previous history of rejection, patient not taking immunosuppressive drugs as advised by the doctor.
Symptoms Of Liver Transplant Rejection:
In some patients after liver transplant surgery, the immune system may not allow the liver to function properly. This is called rejection. The warning signs and symptoms of liver transplant rejection are:
- Fever
- Body pain
- Pale stools
- Jaundice
- Pain in abdomen
- Vomiting and nausea
- Dark yellow or orange colored urine.
- Itching all over the body.
- Swelling of abdomen and legs.
- Severe overall discomfort.
- Cough and shallow breathing.
The rejection may occur immediately after the surgery or within first few weeks or months.
How To Prevent Liver Transplant Rejection?
The primary goal after liver transplant operation is that liver must start functioning properly. Since organ rejection is a major consequence after transplantation, all patients are given immunosuppressive drugs. These drugs suppress the immunity and prevent or treat rejection of liver transplant. These patients need hospitalization for constant monitoring until the condition resolves.
The prognosis of liver transplant rejection in most cases is favorable. The advances in medicine have made it possible. However, in severe cases of liver transplant rejection or if there is delay in diagnosis of rejection, the prognosis is not good.