The number of liver transplant procedures happening in the United States is rising.
In fact, 2021 marked the ninth year in a row that the number of liver transplants increased. For the first time, experts performed 9,236 liver transplants and 569 of the liver transplants performed involved livers from living donors.
With the transplant numbers rising, questions about what to expect after a liver transplant are becoming more common. More individuals wonder how they can help support a friend or family member going through this type of transplant procedure.
There’s no substitute for conversations with your doctor or medical team, but we gathered answers to some questions you may have about life after a liver transplant and how you can help if you know someone going through a transplant.
If your doctor determines that you need a liver transplant, they will connect you with a transplant center and a transplant team will evaluate you. They will notify you when a match is available and when you need to report to the hospital.
At the hospital, there may be about 2 hours before the surgery while you undergo preparations for your anesthetic, blood pressure monitoring, and other preparations. The actual liver transplant surgery generally takes somewhere between 6 and 8 hours and includes removal of the old liver and placement of the new liver.
Following the surgery, your healthcare professionals will take you to the intensive care unit (ICU) for further monitoring before moving you to another area of the hospital, where doctors and nurses familiar with the care of transplant recipients can continue caring for you.
The average hospital stay for a donor and transplant recipient is about a week. Recovery at home for a transplant recipient will continue for several months and you’ll need a caregiver present 24/7 at the beginning of this recovery.
Following a liver transplant, you will need to take immunosuppressants for the rest of your life. These can help prevent your body from attacking and damaging the new liver.
Medications doctors can prescribe to help reduce the chance of your body rejecting the new liver can include:
- cyclosporine (Neoral) or tacrolimus; FK 506 (Prograf)
- prednisone or methylprednisolone (Solu-Medrol)
- mycophenolate mofetil; MMF (CellCept)
In the case of severe rejection, doctors may prescribe OKT3.
Because there can be a wide range of side effects from these immunosuppressants, such as high blood pressure, depression, and headaches, you may also need to take other medications to help manage these side effects.
The liver begins to regenerate almost immediately after surgery. Both a recipient and donor’s liver will almost completely regenerate within 8 weeks.
Following a liver transplant, some things you’ll need to avoid include:
- “live” vaccines
- close physical contact with people who have infectious diseases
- alcohol, cigarettes, and recreational drugs
- unpasteurized milk products, and raw or undercooked eggs, meats, and seafood
- water from lakes or rivers
- walking barefoot outside, which can allow soil microorganisms to get into your body
- pregnancy within the first year post-transplant
While traveling after a liver transplant is typically fine, talk with your transplant team before traveling, especially to developing countries. They can talk with you about how to minimize potential risks.
It’s also important to always wear a medical bracelet or necklace after your transplant so that emergency healthcare professionals will know that you have a transplant.
If you know someone having a liver transplant, you may wonder how you can support them. Some practical ways to offer assistance include:
- helping ensure that they follow their postsurgery medication schedule, which can include putting pills in a dispenser, setting alarms, or contacting them with reminders
- keeping track of and transporting them to required medical appointments and tests
- encouraging lifestyle changes recommended by doctors
- helping prepare balanced, nutritious meals
- offering a listening ear for the range of emotions they may experience
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The biggest risks following a liver transplant include rejection of the new liver and infection. Approximately 60-70% of liver transplant recipients will develop rejection at some point after the surgery, but major medical advances now offer ways to help manage potential rejections.
Other complications can include:
- blood clots
- damage to the bile ducts
- side effects related to the medications the recipient takes to prevent rejection of the new liver
You need medical monitoring and medication after a liver transplant, and you may not feel healthier for up to a year.
Following a liver transplant, there are still many months of recovery ahead.
It’s important to take any medications prescribed by your doctor to reduce the chance of your body rejecting the new organ. Expect to continue to connect with your doctor for frequent monitoring.
It’s important to have a strong support system after a liver transplant. These individuals can help with physical needs like preparing balanced meals and driving you to medical appointments. They can also offer much needed encouragement for any lifestyle changes you may need to make.