Other complications after a liver transplant

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Some complications after transplant do not fall into any set category. As a result, we call them “miscellaneous” complications. They include:

  • medication side effects
  • cancer
  • plasma cell-rich rejection (de novo autoimmune hepatitis).

Medication side effects

Transplant medications can cause mild or severe side effects, depending on each patient.

In general, common side effects include:

  • high blood pressure (which you can reduce with a low-sodium diet and medications)
  • tremors (shaking of the hands)
  • electrolyte (chemical) imbalances in the blood, for example low magnesium or high potassium levels
  • kidney problems
  • stomach upset
  • diabetes, or high blood sugar levels (very rare, caused by higher doses of prednisone and/or tacrolimus). If diabetes does occur, it usually lasts only a short time. You can control it with changes in diet or, sometimes, injections of insulin. Diabetes is often temporary and improves when prednisone is stopped.

As time passes after your surgery, the transplant team will slowly lower your dose of immunosuppressants. This will decrease the risk of experiencing side effects.

It is important to tell your doctor if you are experiencing any unusual side effects, as they may be able to change your medications or doses.


Long-term use of immunosuppressants, which you will need to take after your transplant, increases your risk of developing different types of cancer later in life. For example, all patients have a risk of developing skin cancer and females have a greater risk of developing cervical cancer.

All transplant patients should take steps to prevent cancer, for example by wearing sunscreen to protect the skin​ and talking with the medical team about what routine checks you should have. You can also check out our video about how to examine your skin for changes​.

Plasma cell-rich rejection (de novo autoimmune hepatitis)

Your new liver can sometimes become inflamed (irritated and/or swollen) after transplant. One type of inflammation is called plasma cell-rich rejection (also known as de novo autoimmune hepatitis). Autoimmune means your immune system is reacting to your body and causing inflammation.

The first sign of plasma cell-rich rejection is usually an elevated level of antibodies during liver function tests, or LFTs. If the liver team sees this, they will decide to do a liver biopsy. If the biopsy confirms the plasma cell-rich rejection, your healthcare team will discuss the condition with you and give you medications (usually prednisone to start) to treat it.

If the biopsy confirms de novo autoimmune hepatitis, your health care team will discuss the condition with you and give you medications (usually prednisone to start) to treat it.

Last updated: November 30th 2017