Blood transfusion 10 days after liver transplant

[Prenelope]

My friend had her liver transplant 10 days ago and today has been sent for a blood transfusion and is then going to ICU as they are concerned about her numbers. I naively wasn't prepared for all the post transplant complications. She has a lot of bruising and has been very agitated. I'm quite worried now. How common is internal bleeding after a transplant?

[Richard-Allen]

Hello Prenelope,

I’m sorry to hear that your friend is having this trouble. I think it’s pretty fair to say that no two liver transplants are the same. There is always a risk of complication before the first cut of the surgeon's scalpel. Everything is done before the operation to minimise any possible complications later on.

A person has to be both physically and mentally fit to be able to endure the 5-hour operation.

Many things can go wrong, and these are often unavoidable and make for a much more complicated procedure. Every transplant can be a challenge for even the most skilled surgeon.

I didn’t have many problems with my transplant, but I was told afterwards that because my donor was a lot younger than me, they did have problems connecting up all the plumbing bits (Hepatic vein, portal vein, Hepatic Artery, Inferior vena cava, etc). For me, the inferior vena cava had become twisted and developed a kink in it. This managed to sort itself out after four days, but it did cause me to become breathless if I tried to walk. Because my donor was a lot young than me, my veins and bits were a lot thinner than those of the donor. So connecting everything became a challenge. But I had no lasting after-effects.

So, unit the surgeons open a person up, they don’t know how things are going to go. But are prepared for any possible complications, and sadly as in your friend's case, post-surgical complications can arise.

Your friend is in good hands and it sounds like they are fixing the problem.

Fingers crossed that things all turn out well. Please keep us posted.

Many thanks

Richard

[Prenelope in reply to Richard-Allen]

Thank you so much for your reply. I know they have had a few issues with the connections not being great. She is very mentally agitated and angry which I cant help thinking doesn't help her recovery. I hope you continue to do well.

[AyrshireK in reply to Prenelope]

The mental agitation and mood changes will be medication related as well as the result of undergoing such a massive operation - prednisolone steroid is famous for 'roid rage' plus no doubt toxins are still floating round in her system. It takes a while. A month or so back we had tales of another post transplant patient and their incessant hallucinations due to the drugs and toxins - all these things are normal and should rectify in time. It is very early days.

Katie

[Richard-Allen in reply to Prenelope]

One of the things I forgot to mention was the change in a person's mood, attitude or even depression and a feeling of guilt. What many people don’t realise is that this can all be caused by a response by their immune system.

As you’ll appreciate, a liver transplant is a tremendous assault upon the body. If you imagine yourself say by cutting your finger, or an injury occurs, it causes an inflammatory response by the immune system

The body's immune system jumps into action. Proteins called Cytokines go in search of any invading bacteria, and other proteins called Macrophages devour and destroy the invading bacteria.

It has recently been discovered that when an injury occurs and the immune system jumps into action, these Cytokines can cross over the blood-brain barrier, and alter a person's mental state, and in doing so bring about a feeling of depression and melancholy.

If we now look at the amount of cutting and stitching carried out during the procedure, we can see how the immune system goes into overdrive to try and deal with this massive assault.

I have posted up this video many times in the past, it shows how a person's mood can be changed due to a chemical response by the body's immune system. So, it’s not the person being moody, it’s a bodily response: youtu.be/iw7b0-yTnT0(Not working as expected?)

I hope this helps. Understanding this certainly helped me to get over my survivor's guilt

Richard.

[Bikafella in reply to Richard-Allen]

Thanks for that post Richard - fascinating stuff - the video was very clever and informative.

[Prenelope]

Thank you. Sadly things have taken a turn for the worse and she is currently in surgery for internal bleeding.

[AyrshireK in reply to Prenelope]

Fingers crossed they get everything sorted for her.

Best wishes,

Katie

[Rshc in reply to Prenelope]

so sorry to hear your friend is having such a tough time post op. Hope they get her sorted soon

[Bikafella]

Whilst I was in hospital post transplant they were constantly taking blood samples and doing various scans. It became apparent that I had a large haematoma developing in my abdominal cavity which was getting septic. Biopsies were taken to analyse exactly what was in it so they could treat the amount retained after a substantial qty of fluid was aspirated. They used some very powerful antibiotics which can only be obtained from the hospital. As this was close to my anticipated departure I was fitted with a pic-line so I could take the drugs myself at home. I had two training sessions at the hospital to ensure I was able to do it in as sterile an environment as possible. I had to do this daily for two weeks. It worked well. During this whole time, after the op I was feeling well. I was fortunate.

[BritishLiverTrust3 Administrator British Liver Trust]

Dear Prenelope,

If you [are in the UK and] would find it useful to talk things over, our nurse-led helpline is open Monday to Friday from 9am to 3pm on 0800 652 7330 (excluding bank holidays)

Best wishes

British Liver Trust