Liver Transplant Rejection: Signs, Symptoms, Is It Reversible?

Medically Reviewed by Dr. Aman Priya Khanna
Written by Rajath R Prabhu, last updated on 21 July 2023
Liver Transplant Rejection: Signs, Symptoms, Is It Reversible?

Irregularities in liver functions can initiate diseases that can turn into life-threatening conditions over time. The end-stage liver complications are mainly the ones where the liver processes are hampered, bringing an individual near fatal events. 

At this stage, there are no remedies left to reverse the damage. However, there are greater chances of survival when the scarred liver gets replaced with a new one. Liver transplantation is a surgical procedure that helps restore healthy liver functions.  

In some cases, liver transplant rejection occurs, which is, of course, detrimental to the body. Keep reading to unveil more aspects of it. 

Liver transplant Rejection Types

Organ Rejection is an event in the body where cells from the body's immune system attack the transplanted organ, considering it foreign. Sometimes in Liver Transplants, the risk of rejection can be higher, and the recipient is prescribed medicines that work as anti-rejection agents. Given below are the types of liver transplant rejections. 

Acute Rejection

  1. It is a type whose signs become apparent just after a few days or weeks of the transplant. The primary cause of this rejection is the antibody, i.e. specific type of lymphocytes produced in response to the transplanted liver tissue or graft. 
  2. In case of acute rejection, the symptoms can be improved by using certain medications, such as steroid boluses, which act on the immune system. 

Chronic Rejection

  1. Chronic Rejection brings in more severe symptoms than acute rejection. In this condition, the complications are severe enough not to respond to even high doses of immunosuppressant drugs.
  2. Liver transplant rejection after 2 years or more marks the chronic stage. Chronic inflammation or several adverse immune reactions become evident in the case of chronic liver transplant rejection. 

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Liver Transplant Rejection Symptoms

What happens when the body rejects a Liver Transplant? What are the unusual changes that a body undergoes? The answers to these questions are essentially the symptoms of liver transplant rejection. Though transplant rejection rarely happens after 2 or 10 years, there is still a likelihood of an individual suffering from it. Mentioned below are some signs that should not be ignored: 

  1. One can experience a high degree of pain in the area where the transplant surgery is being performed. Swelling or intense pain in the stomach can be experienced. In some cases, stomach upset, vomiting, diarrhoea, and reduced frequency of urination can also persist.
  2. Changes in mood, such as irritability and continual nausea or fatigue, can be encountered when the body pays for liver transplant rejection.
  3. Frequent headaches accompanied by a fever temperature as high as 38 degrees or above can be a response to organ rejection in the body. 
  4. In some cases, signs of liver transplant rejection include chest pain along with upper abdominal pain. Feeling shortness of breath or uneasiness after little activities can also be seen.
  5. Jaundice symptoms are more likely to arise when the body rejects a transplanted liver. This is because bile reverts into the bloodstream, which in turn loads the body's various cells with bile pigments. The skin begins to appear yellowish pale, with eyes turning white. Further, the abnormal colour of urine or stool, i.e. brownish yellow, can signify the severe stage of jaundice. 

What happens if your body rejects a liver transplant?

After transplantation, the body either accepts the new liver with medical assistance or rejects it. Several abnormalities can begin in the body when the liver transplant rejection occurs. Given below are some of those anomalies: 

  1. A body's vascular system can be potentially affected due to liver graft failure. Complications such as Hepatic Artery Stenosis or HAS can happen to patients who have undergone an orthotopic liver transplant. When not detected or treated on time, this can progress to the thrombosis stage, impairing liver functions and disturbing other body parts' functions.
  2. Problems in the biliary tract are common in case of liver transplant rejections, i.e. 1 out of 10 liver transplant patients can experience biliary complications. Damage to the bile tract can lead to bile leakage or obstruction in the passage of the bile duct due to the scarring of the surrounding tissues. 
  3. Blood flowing from and towards the liver can also have problems. Bleeding or haemorrhage in the blood vessels can be seen when the body rejects the newly transplanted liver. Also, one of the signs of liver transplant rejection is recurrent infection or disease. 

Liver Transplant Rejection Demography

  1. A new organ being introduced in the body by replacing the old one sometimes brings in complications. This is because the body's immune system tends to respond against it.
  2. It is found that 1 in 3 people undergoing liver transplantation faces rejection, i.e. the cells of the immune system attack the body's own organ. However, such issues can be corrected through various medical means only if they are availed at the right time. 
  3. The cases of chronic liver rejections are fewer, i.e. 2 in 100 liver transplant patients can encounter this. The chronic stage occurs later, and the chances of acute rejection are higher in the first two weeks, i.e. the initial 12-14 days just after the transplant procedure.
  4. The survival span of liver transplant patients is as long as 10 years, though some people even survive up to 20 years.

Liver Transplant Rejection Prevention

A liver transplant is a sensitive procedure that is executed with immense care. There are several tests done for matching donor compatibility before allotting the surgery. Also, some preventive measures are expected from the patient's side before and after surgery so that the risk of organ rejection reduces significantly. Signs of liver transplant rejection can be prevented if the following actions are undertaken on time: 

  1. Consuming a balanced and healthy diet after the transplant is essential. Consider seeking professional help, i.e. consulting a nutritionist to provide a proper diet chart. 
  2. Also, it's vital to strictly stay away from unhealthy lifestyle patterns that could put the new liver under stress. For example, avoiding alcohol intake, ingesting unhealthy or fat-loaded food, etc.
  3. Immunosuppressive medicines are the primary facets for preventing liver transplant rejection. For each liver failure patient undergoing a transplant, it is crucial to rely on anti-rejection or Immunosuppressive medicines after surgery for a lifetime to survive healthily. Such medicines help to weaken the immune responses against the new liver so that no side effects are seen in the body. 
  4. Every patient responds differently to various drugs. Thus, considering the medical history, degree of recovery, and other crucial internal factors, the medical practitioners decide an individual's doses of the Immunosuppressants. 
  5. Routine medical follow-ups are indeed life-saving as they can relieve the liver transplant recipient from other infections or diseases too. 
  6. Due to the continual immunosuppressant medicines, an individual is highly prone to ailments besides liver transplant rejection symptoms. 
  7. Thus, it's better to call for frequent health checkups, preferably once a week after the surgery for about one year. Later, the frequency can be reduced depending on the patient's condition.
  8. Also, the patient can be asked to assess liver and kidney functions through various medical tests.


Better late than never! Health ignorance navigates toward liver failure. Still, the advancements in the medical sphere in the form of therapies or liver transplant surgeries help an individual survive. However, negligence at the later stage is not at all desired as liver transplant rejections can prove to be lethal. 

Thus, improving the symptoms of liver transplant rejection at the right time can be a wiser decision one can make for themselves. 

Can Liver Transplant rejection be reversed? 

The answer is still yes if the rejection is acute and cannot take the chronic path. Availing efficient medical assistance from the very beginning can dismiss all the health crises related to a liver transplant. It's always better to rely on the experts for every medical treatment, no matter how minor or major. 

HexaHealth brings numerous health facilities that can be considered during illnesses. The highly experienced and qualified medical professional team at HexaHealth holds brilliant strength to provide promising health advice or treatment. 

Frequently Asked Questions

Can your body reject a liver transplant years later?

Yes, the possibilities are less, but a liver transplant can be rejected by the body after years too. Usually, organ rejection happens in the first six months of the surgery. 

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How many years can a liver transplant last?

It is found that about 75% of liver transplant patients can have a decent survival rate for about five years, followed by regular health checkups.  

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How do you know if your body is rejecting a liver transplant?

When the body does not accept a new liver, it features symptoms of liver transplant rejection, such as abdominal pain, jaundice, high fever, and so on.  

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How long after the transplant does rejection occur?

In most cases, the rejection happens during the first six months of the surgery itself; however, in a few cases, liver transplant rejection after 2 years is also seen. 

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Can liver transplant rejection happen after 10 years?

Liver transplant rejection after 10 years is a very rare phenomenon though it can still happen, i.e. if the symptoms are not corrected at an early stage. 

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What are the signs and symptoms of liver transplant rejection?

The common signs and symptoms of liver transplant rejection are high fever, frequent abdominal pain, jaundice, less urination, irritability,  nausea, fatigue, shivering, etc. 

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Can liver transplant rejection happen after 2 years?

Liver transplant rejection after 2 years can happen only in rare conditions where the acute rejection turns chronic. 

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Can liver transplant rejection be reversed?

Liver transplant rejection can be reversed with the help of immunosuppressive medicines when the rejection is at the acute stage. 

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What happens when your body rejects a liver transplant?

When the body begins to reject a liver transplant, other complications arise, such as problems in the bile duct, infections, blood clots, issues with the kidneys, and so on. 

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Can you get a second liver transplant?

When the first transplant fails, there is an option of planting the second liver; however, the later process is more complex than the initial one, with fewer survival chances. 

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What is the longest liver transplant survivor?

Liver transplant recipients can survive up to 30 years after the surgery with proper medical care or routine follow-ups. 

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Can you have three liver transplants?

Performing a liver transplant multiple times is a complex procedure that reduces the survival chances. However, it can be opted for by medical practitioners when no other option is left. 

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What is the number one cause of liver transplants?

Liver failure or liver cirrhosis is the topmost cause of liver transplants.
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What happens to the old liver after the transplant?

The old liver left after the transplant is usually the diseased one with zero functionality; thus, it cannot be used for anything. 

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What is the most common complication of a liver transplant?

The most common complication of liver transplantation is high blood pressure which can be caused as a side effect of the immunosuppressive medicines. 

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Can you drink alcohol after a liver transplant?

It is usually advised to refrain from drinking alcohol for about six months or more after the liver transplant. Though,  it's always better not to drink at all to help the new liver adapt well in the body. 

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Updated on : 21 July 2023


Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More


Rajath R Prabhu

Rajath R Prabhu

MSc. Clinical Research I PG Diploma in Public Health Services Management

3 Years Experience

His work in medical content writing and proofreading is noteworthy. He has also contributed immensely to public health research and has authored four scientific manuscripts in international journals. He was assoc...View More

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