Liver Transplantation: Early and Long Term Management and Complications

Post liver transplantation care begins with immunosuppression induction and maintenance and continues with close monitoring of graft function as well as renal, metabolic and infectious diseases complications. A number of recipient, donor and operative factors influence post-operative complications. Neurogenic, cardiovascular, renal, gastrointestinal and metabolic side effects may manifest early or later in the post-transplant period, while primary disease recurrence and malignancy issues most often manifest later in the course. With improvement in survival rates after liver transplantation, due to advances in surgical techniques and immunosuppression drugs, non-transplant related causes like cardiovascular disease and de novo malignancies are becoming responsible for most late deaths in the recipients. Liver transplant recipients hence require a multi-disciplinary team approach from day one after the transplant followed by a tailored screening and health maintenance regimen.