drainage after one month liver transplant

[LeeNY61]

I am 50 years and got liver tranplant ~1.5 month ago and it's been two weeks since discharge. I had cirrosis from Hep-B.
I have a complication of bile-leak and I discharged with two drains (left and right).  The left one was taken out one week after discharge (due to low discharge).  The right one is still filling by 60~65cc per day.  

I have a fever today (~100F) and see some scums (small floating things inside the J-P, leak container).
The leak has a light yellowish color. I do not know whther the fever and the floatings have some relation or not.

Should I call to the liver team ?

[LeeNY61]

thanks.  For me, the drain keeps comming even if it is getting reduced.
I have no fever.  However, I have a concern of what is draining-out. Before it was clear color with no impurity, but it is now murkier and sticky with some fishy-like smelly (bad smell) tissues.

I asked the doctor to start anti-biotic IV and he seemed to hegitate because I do not have a fever and am doing well.  He expecs the  amount of drain fells out on it's own soon.

When you have infection, did you see the drainage change (color, impurity, smell, etc) ?

LeeNy61

[LeeNY61]

Thanks,
I did not take the antibiotic IV because the doctor did not want.
The drain is falling down to 30cc (30ML) now, but it is very sticky & murky (with  yellow).
Mine is not connetced to a duct, but to a cavity inside the belly per the doctor.
In any way, we will see the doctor on Wend and he will decide.

Thanks a lot for the information. Your sharing is greatly helpful for us.

LeeNY61

[STU426]

Yes it got smelly and yellow, green in color,. my drain was connected to a bile duct, so the liver thought it was draining normally., it put put 100ML or 4 oz every day.,   I don't think you should take antibiotics unless you have a fever, as it usually passes.  you don't want to take antibiotics too much as you can build a resistance to them,.. I know it's scary in the beginning but don't worry too much,  the team @ NYP is good especially the In Patient team.,  they know what to do. if you ever want to email me directly
***@****    I am glad to help from my experience.

[STU426]

I went through the same thing several times that's when I realized if the fever wasn't too high under 100.5.  I would wait because by the time I got there the fever had gone down and there was noting they could do.  I went in on the Thursday before labor day and they treated the fever with antibiotics Unfortunately none of the regular doc were in so I had to stay till Tuesday and they returned. Good news is the drain fell out on it's own,  and once I cleared the infection I have been fine and drainless since,
Your transplant is so new, you have to be more careful until you know what to expect.

Stu426

[LeeNY61]

yes. I got it Columbia. In fact, I called the doctor last night and he talked to me to come to the hospital today even if today is holiday.  Today, I do not have a fever (back to normal since last night bed time). He said the white things are tissue and the tissues can make some smell. Since there is no fever now, he said there is nothing he can do for me.  He took the sample from the drainage to find out more.  The nurse replaced the J-P with the new one. I am home now and there is no fever.  Interestingly, I see very small leak filling the J-P container  and the tube seems to be filled with some stickly tissue.  I am not sure whether the bile leak is stopped or simply blocked with the sticky thing. I have a clinic visit the day after tomorrow and I will show it.  Hoping that the leak is stopped and I can pull the drain. Thanks for all of your sharing.

[Thomas D Schiano, MD]

i agree with all of the above.  you will be OK but I still recomend informing your transplant team.

[STU426]

I am 1 3/4 years out from living donor LT,  so ducts are always a concern in LD,  I had the same issue after tnplt,  I  had a billiary drain for 9 months. I noticed that if I got some whiteish material and fever it usually was an infection.,  but I would wait until at least the holiday is over.  If your fever clears you should be fine   f not you can always go in tomorrow when the doc are back.
Are you a Columbia Trsnplt?  I got mine there in sept. 08.

[billpb1222]

lee,

i am just six months out at age 51.  what you describe sounds very familiar to me.  i assume a 1.5 months you must be seeing your team pretty regularly.  you should call your nurse coordinator if for no other reason than increasing the development of your relationship.  you will feel at ease and they will gain more confidence in you by calling with your concerns.  congrats!  my email is ***@**** if you want to discuss anything.  i find it helps.  i live in Boston area and my transplant was done at the Lahey Clinic.

shrink the negative, stay positive, stay well,

bill