What are Symptoms of a Liver Transplant Rejection?

Liver transplant and graft patients can suffer complications if the transplanted organ is rejected by the body. Although doctors try to match donors to recipients by tissue and cell type, rejections can still occur when the immune system identifies the transplanted tissue as foreign. Some common symptoms of liver transplant rejection include fever, abdominal pain or swelling, irritability, fatigue, discolored skin, and discolored urine. While many of these symptoms are mild and are often part of the recovery and adaptation process, prolonged or more extreme symptoms can indicate a rejection. Patients suffering rejection symptoms should consult a medical professional immediately.

The less extreme symptoms of rejection — such as fever, exhaustion, moodiness, headaches, and itching — may also be caused by other conditions, but should not be dismissed, especially if they persist for longer than expected. In the instance of fever, a temperature higher than 100°F (37.7°C) is a strong sign of tissue rejection, though even a small increase in body temperature can indicate a problem. Pain, tenderness, and tissue swelling in the abdominal area can be caused by post-surgical contusions or infections, but could also signify tissue rejection. Should two or more of these symptoms occur in tandem, they may be as firm an indicator of transplant rejection as the more severe side effects.

More distinct reactions can include clay-colored stools, jaundice, and brown urine. These signs are less easily mistaken for other ailments, and point more certainly towards liver transplant rejection. Since the liver processes toxins in the body, discolored skin, stool, and urine usually indicate improper liver function or failure. Regular liver-function testing can also pinpoint early-stage or advanced transplant failure.

Some patients suffer no symptoms of liver transplant rejection until the transplanted organ fails. These people are often at the highest risk of severe side effects because they lack the early warning signs. Liver transplant patients, even those who seem to be recovering well, should be monitored closely for any signs of sudden failure or rejection, and should receive emergency care immediately if the transplant fails.

Anti-rejection medications are usually prescribed to help the patient's body adapt to the presence of foreign tissue. Many transplant patients are required to maintain a drug regimen for the rest of their lives to prevent late-stage tissue rejection. Although the medication is often successful, in some cases, the patient's body develops a tolerance over time and can still reject the transplanted liver after months or years without incident. Regular monitoring and medical care are required to ensure proper liver function, and prevent later liver transplant rejection.