Acute rejection is most commonly treated with high-dose steroids (prednisolone 200 mg or methylprednisolone 1 g for 3 days) or a high-dose steroid bolus followed by a rapid taper over 5-7 days. These treatment regimens are effective in 65-80% of transplant recipients.
Neoral ® (cyclosporine)
This medication is given to prevent rejection of the transplanted liver. It must be taken every twelve (12) hours. The prescribed dosage may be changed frequently to maintain an appropriate blood level.
Prednisone is a steroid medication given to prevent and treat rejection after transplant. It will be given in higher doses for the first few months and is tapered to a smaller maintenance dose thereafter.
After the transplant, you must take medicine to keep your body from rejecting the new liver. You will need to take anti-rejection medicine every day from now on. These medicines have side effects. One side effect is that your body may be less able to fight infections.
Preventing Rejection and Fighting Infection
You'll also be prescribed medications to help prevent infection after transplant surgery. These are typically taken for three to six months until your immune system is strong enough to defend itself against infection.
Chronic rejection usually leads to the loss of bile ducts (ductopenia). Another liver transplant may be needed. Rejection is suspected when the liver starts to work less well. This is usually first picked up on blood tests.
After an organ transplant, you will need to take immunosuppressant (anti-rejection) drugs. These drugs help prevent your immune system from attacking ("rejecting") the donor organ. Typically, they must be taken for the lifetime of your transplanted organ.
Take the capsule every morning, preferably on an empty stomach, at least 1 hour before or at least 2 hours after a meal. Do not drink alcohol with the capsule.
Avoid alcohol
If your liver transplant was due to an alcohol-related disease, you must never drink alcohol again as you risk harming your transplanted liver. This also applies if alcohol was thought to have contributed to your liver disease, even if it was not the main cause.
Unfortunately, these missed doses or forgotten medications can lead to serious problems in transplant patients including acute rejection, chronic transplant damage and ultimately the failure of a transplant.
Immunosuppressant antibody opens up new treatment path for chronic transplant rejection. Once a transplant patient gets past the first week to three months with their new organ, the risk of rejection drops substantially—at least for the first year.
In heart transplants, the rate of organ rejection and patient mortality are the highest, even though the transplants are monitored by regular biopsies. Specifically, some 40% of heart recipients experience some type of severe rejection within one year of their transplant.
By taking anti-rejection medications your immune system is lowered enough for you to safely keep your organ. It is essential that you take anti-rejection medications at the same time every day and 12 hours apart to avoid missing doses and to keep consistent blood levels of the medication in your body.
Your medications after transplant are expected to cost between $5,000 and $7,000 per month. You will need to take approximately 10 medications during the initial period following transplant.
What should I avoid eating after my liver transplant? Grapefruit and grapefruit juice can affect how well some immunosuppressants work. To help prevent problems with some of these medicines, avoid eating grapefruit and drinking grapefruit juice.
What the most common infections? Chest infections are very common after a liver transplant. Usually these infections are fairly easy to treat with a short course of antibiotics. These are usually successfully treated with antibiotics.
“Fifty percent of the transplants we did last year were on account of alcohol.” Nationally, Burton said, about 40% of liver transplants are due to alcohol-related illness, and national data show a spike in liver transplant referrals after March 2020.
Anti-rejection medicines can have some side effects. Some of the most common side-effects of anti-rejection medicines can include higher blood pressure, higher blood sugar, weight gain, an increased chance of having infections, and increased risk of some forms of cancer.
Most foods and drinks are completely safe for you to take after transplant. Please AVOID grapefruit, pomegranate, pomelo, blood orange, and black licorice, as these can increase the amount of anti- rejection medication in your body and this could harm you.
Does tacrolimus interact with any foods or beverages? Avoid excessive intake of high potassium foods (bananas, oranges, orange juice, potatoes, spinach, etc). Do not eat grapefruits, grapefruit juice or any soda (Fresca) or fruit juice blend that contains grapefruit juice.
While transplanted organs can last the rest of your life, many don't. Some of the reasons may be beyond your control: low-grade inflammation from the transplant could wear on the organ, or a persisting disease or condition could do to the new organ what it did to the previous one.
Avoid unpasteurized beverages, such as fruit juice, milk and raw milk yogurt. Avoid salad bars and buffets. Refrigerate pate, cold hot dog or deli meat (including dry-cured salami and deli prepared salads containing these items), eggs or seafood. Consume only pasteurized milk, yogurt, cheese and other dairy products.
Cornea transplants are rarely rejected because the cornea has no blood supply. Also, transplants from one identical twin to another are almost never rejected.