Infection after a liver transplant

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Boy lying in bed with thermometer in mouth

The immunosuppressants (anti-rejection medications) that you take to prevent rejection also make your immune system weaker. This makes it easier for you to get infections.

You can do a few things to help you stay as healthy as possible and lower your risk of infection.

  • Wash your hands often – after using the wash room (of course), before preparing and eating food, before and after preparing your medications and after touching pets or surfaces in public places such as door handles. If you are in a place where you are not able to wash your hands with soap and water, you may use a hand sanitizer.
  • Do not share drinks or eating utensils.
  • Follow basic food safety, for example by eating freshly-cooked food, whenever possible, reheating food thoroughly and storing food at the right temperature. Avoid buffet-type restaurants, where cooked food has been left under hot lamps, sometimes for hours.
  • Stay away from anyone who is sick with the flu or an infection​, even if it’s just a cold, especially in the first couple of months after your transplant. They may not cause much harm to most people, but they could make you very unwell.
  • Stay away from certain pets for a couple of months. You can find more information about keeping pets in the module about preparing for discharge.
  • Make sure that you take all of your anti-infective medications​ as prescribed.
  • Your transplant team will regularly check for certain viruses such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV). If these viruses become active, you will need anti-viral medicine. Sometimes the transplant team will also lower your dose of anti-rejection medications to help you fight off the infection. Never reduce your medications without instructions from your transplant team.
  • Get as many of the required vaccines or shots as possible before your transplant so you will be protected afterwards. Remember that you cannot have a live vaccine (for example a vaccine against chicken pox or measles/ mumps/rubella) while you are taking anti-rejection medications. You can have other (non-live) vaccines six months after transplant once your body is better able to respond to the vaccine and make antibodies.

Post-transplant lymphoproliferative disorder (PTLD)

Infection with Epstein-Barr virus, also known as infectious mono or “kissing disease”, can cause a unique disease in transplant patients called post-transplant lymphoproliferative disorder (PTLD). With this disease, certain cells, called lymphocytes, grow much more quickly than they should. Although it happens rarely, the cells can, over time, lead to a form of cancer called lymphoma. This happens to a very small number of patients.

Patients with EBV will have frequent monitoring to prevent PTLD. Treatment for PTLD includes reducing the doses of immunosuppressants and giving anti-viral medicines. This treatment has been very successful. Occasionally, the transplant team may need to give anti-cancer medications (chemotherapy). Patients with PTLD will be monitored frequently to check if there is a risk of lymphoma.

Last updated: November 30th 2017