Complications of liver transplant 

Complications of a liver transplant can include rejection, an increased risk of infection, graft failure, biliary conditions and a higher risk of developing certain conditions – including some types of cancer.

Liver rejection

In up to one in every three people, the immune system attacks the new liver and stops it from working properly. This is known as rejection and it usually occurs in the weeks or months after a transplant.

Rejection can occur without causing any specific symptoms, although possible signs can include:

In most cases, rejection can be successfully managed by altering your dose of immunosuppressant medication.


As immunosuppressant medication weakens your immune system,  they can make you more vulnerable to infection.

Do what you can to reduce your risk of picking up infections. As a precaution, you may be given a course of antiviral medication, antibiotics and/or antifungal medication for a few months after your transplant, to reduce your risk of picking up infections.

If you think you may have an infection, contact your GP or transplant centre for advice. Prompt treatment may be required to prevent serious complications.

Common symptoms of infection include a fever, headaches, aching muscles and diarrhoea.

Biliary conditions

After a liver transplant, more than one in every 10 people experience a problem affecting their biliary tract, such as a bile leak or an obstruction caused by scar tissue in the bile ducts.

If you have a bile leak, the bile may need to be removed from the abdomen by inserting a drainage tube.

Obstructions in the bile ducts can often be treated with an endoscopy – where a short tube called a stent is inserted to allow bile to flow more freely – although further surgery may be needed.

Kidney failure

Kidney failure affects up to one in every three people with a liver transplant, usually as a side effect of taking immunosuppressant medication.

Kidney failure happens when the kidneys lose their function and are no longer able to filter out waste products from the blood.

Symptoms of kidney failure can include:

Your doctors will closely monitor your kidney function and the level of immunosuppressant medication in your blood during your follow-up appointments to detect potential kidney problems.

If your kidneys do fail, you will need to have dialysis (where a machine is used to replicate kidney function) or a kidney transplant.

Graft failure

Graft failure is a medical term meaning that the transplanted organ is not working properly. It's one of the most serious complications of a liver transplant and occurs in around one in every 10 people.

The most common cause is a disruption to the blood supply to the transplanted liver, caused by blood clots (thrombosis).

Graft failure can develop suddenly, or slowly over a longer period of time. Symptoms can include jaundice, fluid retention (oedema), mental changes and a swollen tummy.

Medication can stabilise the body in the short term, but the only cure is to transplant a new liver into the body as soon as possible.


People with a transplanted liver have an increased risk of developing some types of cancers, such as:

There is also around a one in 50 chance of developing a type of cancer that affects the white blood cells in people who have had an organ transplant – known as post-transplant lymphoproliferative disorder (PTLD).

Due to the risk of these conditions, it's important to attend all of your follow-up appointments and any cancer screening tests you're invited to. You should also avoid prolonged exposure to sunlight or artificial forms of ultraviolet light, such as sunbeds or sun lamps.

Page last reviewed: 12/01/2015

Next review due: 12/01/2017