LONG-TERM THERAPY AFTER LIVER-TRANSPLANTA TION

The success of a liver transplant may be jeopardised by many complicat ions. 70% of acute organ rejections and 50% of serious infections occu r within the first three weeks of surgery The consequences of HBV or H BC virus reinfection or the undesirable effects of immunosuppressive d rugs (nephrotoxicity, hypertension and diabetes mellitus) are often no t seen until the rehabilitation phase, i.e. the 6th to 12th postoperat ive weeks. Ultrasonography may be used for evaluating seromas, bilioma s, haematomas and vascular complications. During this phase strictures of bile ducts also occasionally occur which necessitate therapeutic i ntervention. The patient must be fully informed about the need for fol low-up investigations to monitor the intensity of immunosuppression. I t has not yet been clarified whether immunosuppressive therapy may eve ntually be withdrawn for those few patients who develop immunotoleranc e after liver transplantation.