Your Liver Transplant: The Procedure

A liver transplant is a major surgery. During a liver transplant, your diseased or injured liver is removed. It’s replaced with a healthy donor liver. Most transplanted livers work well many years after surgery. The information below explains more about what to expect.

Before transplant surgery

If you are on a national waiting list, you will get a call from the transplant team coordinator when a liver from a deceased donor is found. If a living donor is willing to donate part of their liver, you won't need to be on a waiting list. When you arrive at the transplant center or hospital, your health will be checked. You and the donated liver will be tested before surgery. This is to make sure that:

• Your body is healthy enough for surgery

• The donated liver matches your blood type

• The donated liver is the right size for your body

Certain situations may come up that cause your surgery to be delayed. These include a current or recent illness, changes in the health of your liver, or problems with the new liver. This can be frustrating. Try to remember that your transplant team is making the best decision for your health.

During transplant surgery

A liver transplant can take  up to 8 hours or longer. You will be given general anesthesia. This is medicine that allows you to comfortably sleep throughout the surgery. The diseased liver is taken out of your body. Your gallbladder is also removed. The donor liver is put in. Blood vessels and bile ducts are then attached to your new liver.

After surgery

You will stay in the hospital for up to 2 weeks or longer. You may be in the ICU (intensive care unit) for a short time after surgery. During this time, you may be on a machine to help you breathe (ventilator).

Your healthcare providers will closely monitor your health and liver function. As you heal, you will have tests to see if the new liver is working properly. These may include ultrasound tests, a liver biopsy, and blood tests. You will learn about your medicines and how to care for yourself when you go home. In some cases, a second surgery may be needed before going home. This is done to look at how the liver is doing.

Caring for yourself at home

Your healthcare provider will tell you how to care for yourself and your new liver. You will need to be examined by your provider often. This is so they can check for signs of a problem. Problems to watch for include:

• Infection

• Complications from the surgery

• Reactions to the medicines

• Organ rejection

• The original liver disease comes back

• New conditions occur from the medicines, such as diabetes, high blood pressure, or high cholesterol

It's important to not drink alcohol after a liver transplant.

What is organ rejection?

Your body's immune system fights germs. It also protects against foreign things that may cause your body harm. When an organ is transplanted, your immune system sees the new organ as a foreign material. It starts to fight the new organ. This is called organ rejection.

You will need to take antirejection medicine. It prevents the immune system from fighting the organ. You take these medicines for the rest of your life. Talk to your healthcare provider about the benefits and risks of this medicine. Make sure that all your other healthcare providers know you take this medicine.

When to call your healthcare provider:

Call your healthcare provider or seek medical care right away if any of these occur:

• Fever of  100.4° F ( 38.0°C) or higher, or as advised

• Shaking chills

• Vomiting or diarrhea for  24 hours or longer

• A lasting cough, or coughing up green or yellow mucus

• New or worse swelling in your hands, arms, feet, ankles, belly (abdomen), or face

• Bleeding from your nose, mouth, or rectum

• Bloody stools or pee

• Black and tarry stool

• Bruising more easily than normal

• A new or severe headache

• Can’t take your prescribed medicine

• Signs of organ rejection:

  • Abnormal tiredness or loss of appetite

  • Orange or brown-colored pee

  • Pale or clay-colored stools

  • Fever

  • Belly feels sore

  • Belly or liver pain

  • Yellowish color to your skin or eyes (jaundice)