Your Liver Transplant: The Procedure
A liver transplant is major surgery. During a liver transplant, your diseased or injured liver is removed. It’s replaced with a healthy donor liver. Most transplanted livers are still working well one year after surgery. This sheet tells you more about what to expect.
Before transplant surgery
If you have been on a waiting list, you will receive a call from the transplant coordinator once a donor liver is found. When you arrive at the transplant center or hospital, your health and condition 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
Some things could make your doctor postpone the surgery. 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 the doctors are making the best decision for your health.
During transplant surgery
A liver transplant can take 4 to 12 hours. You will be given medicine that prevents pain and makes you sleep during surgery (general anesthesia). The diseased liver is taken out of your body and replaced with the new liver. The blood vessels and bile ducts are then attached to the new liver.
You will stay in the hospital for 1 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 (a ventilator). Skilled nurses and doctors will closely watch your health and liver function. As you heal, tests will be done to see if the new liver is working right. These may include ultrasound tests, a liver biopsy, and blood tests. You'll learn about your medicines and how to care for yourself when you go home. In some cases, your doctor will do a “second look” surgery before sending you home.
Caring for yourself at home
Your healthcare provider will give you instructions on how to care for yourself and your new liver. You will need to see your doctor a lot. This is so he or she can check for signs of a problem. Problems to watch for include:
Complications from the surgery
Reactions to the medicines
What is organ rejection?
Your body's immune system fights germs. It also protects against foreign materials that may enter your body and cause an infection. When an organ is transplanted, your immune system thinks the new organ is a foreign material and starts to fight the new organ. This process is called rejection.
Antirejection medicine prevents the immune system from fighting the organ. You will need to take these medicines for the rest of your life. Talk to your healthcare provider about the benefits and risks of taking these medicines. Be sure that all of your other doctors and healthcare providers know that you are taking antirejection medicine.
After transplant surgery, call your healthcare provider if you:
Have a fever of 100.4°F (38.0°C) or higher, or as directed by your provider
Vomit or have diarrhea for 24 hours or longer
Have a persistent cough, or cough up green or yellow mucus
Have new or increasing swelling in your hands, arms, feet, ankles, belly (abdomen), or face
Bleed from your nose, mouth, or rectum
Have bloody stools or urine
Have black and tarry stool
Bruise more easily than normal
Have a new or severe headache
Can’t take your prescribed medicine
Have signs of organ rejection:
Unusual tiredness or loss of appetite
Orange or brown-colored urine
Pale or clay-colored stools
Belly feels tender
Belly or liver pain
Yellowish color to your skin or eyes (jaundice)
March 21, 2017
Long-Term Management of the Successful Adult Liver Transplant: 2012 Practice Guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Lucey, MR. Liver Transplantation. 2013;19(1):s3-26.
Fraser, Marianne, MSN, RN,Lehrer, Jenifer, MD