LONG-TERM THERAPY AFTER LIVER-TRANSPLANTATION

The success of a liver transplant may be jeopardised by many complications. 70% of acute organ rejections and 50% of serious infections occur within the first three weeks of surgery The consequences of HBV or HBC virus reinfection or the undesirable effects of immunosuppressive drugs (nephrotoxicity, hypertension and diabetes mellitus) are often not seen until the rehabilitation phase, i.e. the 6th to 12th postoperative weeks. Ultrasonography may be used for evaluating seromas, biliomas, haematomas and vascular complications. During this phase strictures of bile ducts also occasionally occur which necessitate therapeutic intervention. The patient must be fully informed about the need for follow-up investigations to monitor the intensity of immunosuppression. It has not yet been clarified whether immunosuppressive therapy may eventually be withdrawn for those few patients who develop immunotolerance after liver transplantation.