Your child’s organism may perceive the new liver as a foreign body and try to attack it in order to destroy it. This condition is called rejection. This does not necessarily mean that the transplant has failed. In general, when rejection is detected in time, it can be treated. Most of the patients who received a graft will experience at least one episode of rejection. Episodes of rejection are more frequent during the first three months after the transplant, however, your child will always be at risk. Anti-rejection drugs, such as Prograf®, diminish the activity of your child’s immune system in order to prevent his organism from considering the transplanted liver as a foreign body.

Rejection may occur when the level of immunosuppression is too low. This level may fall when your child suffers from diarrhoea or vomiting or when a dose of the immunosuppressive agent was missed for whatever reason. When your child is suffering from vomiting or diarrhoea for more than 12 hours, call the Centre as soon as possible. NEVER INCREASE, REDUCE OR MISS a dose of any drug without the transplant team’s consent. Call the Centre when a drug dose was missed for whatever reason.

Chemical changes observed in your child’s blood (liver enzymes) often constitute the only sign of an episode of rejection. Most of the episodes of rejection are confirmed or diagnosed by means of a liver biopsy before the treatment is initiated. This is why it is extremely important that you do not miss an appointment at the hospital or a blood analysis. The treatment for rejection may comprise high doses of steroids (Prednisone® or Solumedrol®), Prograf® (FK506) or Cellcept® (mycophenolate mofetil). In case of confirmed rejection, your child must probably be hospitalised to undergo treatment for about a week.