The liver is truly the unsung hero in the human body. Your liver has hundreds of vital functions. These include filtering toxins that you breathe and eat, storing sugars and vitamins your body needs for energy, and helping your immune system prevent and fend off infections.

Hepatitis C threatens your liver health. Many people with acute hepatitis C don’t have symptoms. Chronic hepatitis C symptoms are usually vague and include fatigue and depression.

You can’t survive without an efficient liver — but the vast majority of hepatitis C cases can be cured with antiviral treatment that lasts just a few weeks and causes few side effects.

A liver transplant may still be necessary, though, depending on the extent of damage caused by hepatitis C.


Hepatitis C is considered acute during the first 6 months after you contract the hepatitis C virus (HCV). Your immune system may be sufficient in fighting off acute HCV. However, most cases of untreated acute hepatitis C go on to become chronic.


When your immune system is unable to fight off HCV within 6 months, hepatitis C can become chronic. HCV can damage bile ducts, compromising the delivery of nutrients to your intestines.

Over years, HCV damage leaves scar tissue that blocks blood flow through your liver. Cirrhosis occurs when scarring causes the liver to function poorly. Other complications of untreated HCV include liver cancer and liver failure.

Treatment for chronic hepatitis C involves 8 to 12 weeks of oral medication. This treatment can cure about 9 in 10 cases of HCV. Treatment helps to prevent cirrhosis and may even reverse some liver scarring.

If HCV remains untreated and causes severe scarring and cirrhosis, your liver will eventually begin to fail and you may require a liver transplant. This amount of liver damage takes around 20 years to develop.

What your doctor needs to know

Liver transplants are recommended only for people who don’t have any other treatment options.

Before you begin the transplant process, your hepatologist, infectious disease specialist, or gastroenterologist will determine if you’re a candidate for a liver transplant. Your doctor and the transplant center team want your body to have the best chance of accepting the new organ.

To choose liver recipients, doctors consider a person’s current medical tests, health history, and support system. They want to be confident you’re healthy enough to survive the surgery and that your postoperative care is in place. They also want to understand the severity of your liver disease.

You may undergo several tests, including:

  • a physical exam
  • blood tests
  • urine tests
  • imaging tests of your organs
  • tests to assess the function of your liver, kidneys, and heart

How a transplant works

If you currently have HCV, you may receive antiviral treatment before or after your liver transplant. Your doctor will determine the best timing of HCV treatment for you.

Liver transplant surgery can last 12 hours or more. You’ll be under general anesthesia during this time.

A liver can come from a recently deceased person or a living donor. Most organ donations are from deceased people.

Living donor transplants

For living donor transplants, doctors remove and transplant just part of the donor’s liver. Because liver cells regenerate, both you and your donor will eventually have functioning livers.

Doctors will first screen the donor to be sure they’re healthy enough to undergo the procedure. If the donor is approved, surgery is usually scheduled within 4 to 6 weeks, according to the National Institute of Diabetes and Digestive Kidney and Disease (NIDDK).

The surgeries for living donors and recipients occur simultaneously. Most people can expect to go home within about 1 week of surgery, per the NIDDK. You can get back to your typical activities within about 1 month.

Deceased donor transplants

Recipients of livers from deceased donors usually receive a whole, healthy liver. Sometimes the liver is split in two, with the larger part of the liver going to an adult recipient and the smaller portion going to a child or smaller adult.

If you’re approved for a transplant and don’t have a living donor, you’ll be placed on a national waiting list. You may be on the waiting list for anywhere from under 1 month to 5 years, according to the NIDDK.

How long you’ll have to wait depends on the severity of your liver failure and other factors, such as your blood type. Ask your care team how long you might have to wait for a transplant and how to keep your liver functioning as effectively as possible until your transplant.

Following your surgery, you can usually expect to go home within about 2 weeks and can return to your typical activities within 4 to 6 weeks, the NIDDK says.

More questions to ask

You’ll have plenty of questions to ask your doctor about your transplant surgery. Some questions you may want to consider asking include:

  • Should I be treated for HCV before or after my transplant?
  • What lifelong medications will I need to help my body accept the new liver?
  • What are the side effects of the operation?
  • What is the best way to prevent reinfection?
  • What is a realistic recovery time?
  • What can I expect to happen at the transplant center?

In order to maintain quality of life after your liver transplant, you should:

  • get treated for HCV, if you weren’t treated before your surgery
  • prevent HCV reinfection by:
    • not sharing needles or other substance use materials
    • ensuring tattoo artists use sterile materials, if you get a tattoo
    • not sharing personal items, such as razors
    • practicing protected sex, especially if you’re at greater risk of getting HCV through sex
  • regularly get tested for HCV if you’re at risk of reinfection, including if you currently share drug needles or are undergoing maintenance hemodialysis
  • follow antirejection procedures, so that your body accepts the new organ
  • know the signs of organ rejection
  • adopt healthy lifestyle habits, including a nutritious diet and exercise
  • avoid smoking and alcohol

Your medical team will recommend a postoperative strategy for you. Make sure to keep follow-up appointments with your transplant team and primary doctor so that they can monitor your new liver’s efficiency.

A liver transplant can prolong your life. Remember that you’ll need to get treated for HCV separately to improve your long-term outlook.

Most liver transplants in the United States are due to cirrhosis caused by hepatitis C. In the United States, an estimated 2.4 million people are currently living with HCV, according to the Department of Health & Human Services (HHS). About 51 percent of people with HCV don’t know they have the virus.

Between 75 to 85 percent of people with acute HCV go on to have chronic HCV. Between 5 to 25 percent of people with chronic HCV will experience cirrhosis within 10 to 20 years.

More than 90 percent of people who receive treatment for HCV are cured of the disease.

A successful organ transplant allows you to live longer than you would have otherwise. For how long and with what quality of life depends on many factors, including your age and overall health. Because each case is different, predictions are difficult.

Liver recipients can live for many years after their transplant. Generally, about 72 percent of people who receive livers from deceased donors live at least 5 more years.

Plus, research from 2018 suggests that survival rates have improved significantly in the past 3 decades. This is largely due to improvements in procedures that keep your body from rejecting the transplanted organ. Antiviral treatments also help prevent HCV recurrence. The study authors concluded that most deaths in the years after surgery are linked to metabolic syndrome.

Your healthcare team can help you navigate life after your liver transplant so that you may have an improved quality of life.