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Liver Transplant - Can Their Be Complications?

Written and reviewed by
Dr. Ankur Garg 88% (526 ratings)
M. Ch.(HPB Surgery & Liver Transplant), FEBS, MBBS, MS - General Surgery
Liver Transplant Surgeon, Mumbai  •  18 years experience
Liver Transplant - Can Their Be Complications?

Complications! This one word can bring in all the feelings of insecurity, anxiety, and restlessness. If you are having a liver transplant surgery, a very common question that keeps on disturbing you is the surgery complications that might arise. Some of the problems specific to liver transplantation that may be encountered include Primary non-function, or reduced function of the newly transplanted liver occurs in approximately 1-5% of new transplants. If the role of the liver does not improve sufficiently or quickly enough, the patient may urgently require a second transplant to survive. 

The following are the Liver Transplant Surgery Complications: 

  1. Hepatic artery thrombosis or clotting of the hepatic artery: Hepatic artery is the blood vessel that brings oxygenated blood from the heart to the liver. This kind of thrombosis occurs in 2-5% of all deceased donor transplants. The liver cells (hepatocytes) themselves usually do not receive blood supply from the hepatic artery. The liver cells (hepatocytes) are nourished by blood by the portal blood flow. The bile ducts, in contrast, depend strongly on the hepatic artery for nutrition. So, loss of the hepatic artery flow ( HAT) may lead to bile duct complications. 
  2. Biliary complications: In general, there are two types of biliary problems: leak or stricture. Biliary complications affect nearly 15% of all deceased donor transplants and up to 40% of all live donor transplants. A biliary leak is a condition where bile is leaking out of the bile duct and into the abdominal cavity. Most commonly, this occurs where the donor and recipient bile ducts were sewn together. This is often handled by placing a stent across the connection through the stomach and small intestine and then providing the connection to heal. Bile can also leak from the cut edge of the liver in the case of living donor or split liver transplants. Typically, along the cut edge drain is placed and left during the transplant operation to eliminate any bile that may leak. Sometimes the bile tends to collect in the abdomen and complications can arise. 
  3. Bleeding: A little bleeding after a liver transplantation is normal because of the widespread nature of the surgery and due to liver failure the coagulation factors are critically depleted. Most transplant patients bleed a minor amount and may get additional transfusions after the operation. It is best to consult a doctor if bleeding is substantial. 
  4. Infection: It is important to take precautions as wound created by any operation can be often lead to infection. Liver transplant receivers are also at danger for infections deep within the abdomen, especially if there is an accumulation of blood or bile from a bile leak.

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