FAQ : Complications & risk of rejection

Your child is at a higher risk of developing complications related to an infection, especially a viral one. For example, if transplanted children catch a respiratory illness, such as a cold, they are more likely to develop pneumonia or otitis the next time this happens. This risk is higher immediately after the transplant and decreases over time.

Because of the possibility of severe complications.

CMV can have effects on several organs and cause rejection. In very rare cases, EBV can result in lymphoproliferative syndrome (PTLD), which is a precursor to lymphoma (early stage). And the chickenpox virus can cause many complications in a child who did not develop immunity before transplantation.

A characteristic of these three viruses is that they remain inactive in cells and reappear later, which makes it difficult to treat them. Please feel free to contact the Center if you have any questions.

Your child's body may perceive the graft as a foreign body and try to attack it. This does not necessarily mean that the transplant has failed.

Anti-rejection drugs, such as Prograf®, Cellcept®, or Neoral® decrease the activity of your child's immune system and help prevent rejection. The earlier the rejection is detected, the easier it is to treat.

Yes, especially during the first three months. The risk persists for the rest of the person’s life. Almost all young transplant patients experience at least one episode of rejection.

There are multiple possible complications during and after a liver transplant. They include surgical and medical complications.

Despite all precautions, the following complications are the most common and occur in 5 to 10% of children with transplants. The same figures are found at the other reference centers throughout the world.

• Any surgery can cause bleeding. A child who receives a new liver very often needs a blood transfusion.
• Other complications are directly related to liver transplant surgery:
  • Thromboses (clots) in vessels that have been sutured. Thrombosis of the portal vein or hepatic artery often requires a new operation. 
  • Leakage of bile, which is often treated by the insertion of a drain. 
  • Narrowing of the bile duct most often requires interventional radiologists to insert a bile duct drain. 

There are also other surgical complications, but these occur less frequently.

Medical complications can be classified into three categories:

• Infections (most often viral)
• Rejection
• Side effects of medications required after the transplant can affect other organs    

Your child is monitored very closely, so that we can react quickly to any complication and adapt his or her treatment.

Finally, very rarely, death can unfortunately occur as a result of these complications.
This is why a liver transplant is proposed after long consideration by the parents and our team. Together, the risks and benefits of the transplant have been carefully considered.

A transplant is proposed in one of two situations: 

• If the child’s vital risk with his or her own live ris higher than the risks associated with transplantation.
• If the child’s quality of life or development is seriously compromised.