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Survivorship Guide for Bone Marrow/Stem Cell Transplant
Coping with Late Effects

Liver Conditions

The liver performs a variety of essential functions, including breaking down medications so that the body can use them, removing toxins, producing proteins that play a role in blood clotting, producing bile that aids in digestion, and removing bilirubin, which is produced when red blood cells die. Liver function can be damaged by many factors after a transplant, including GVHD, viral hepatitis, bacterial and fungal infections, iron overload from multiple red blood transfusions, and drug toxicity. If liver inflammation (hepatitis) develops, it is important to determine whether it is caused by GVHD, a viral infection, or another condition, so that it can be treated appropriately. In some cases, liver damage can result from more than one condition. A liver biopsy can be helpful in determining the main cause of the damage.

If your liver damage is minimal, there are often no symptoms, and the only signs of the damage are elevated levels of blood bilirubin and liver enzymes. When damage to the liver is mild or moderate, it tends to be temporary and reversible with treatment. If liver disease progresses, additional symptoms can include jaundice, which is a yellowing of the skin and eyes, itching, and loss of appetite.

My liver enzymes have been high for a number of years, but the good news is that I have no symptoms.

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