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by EBSCO Medical Review Board

Definition

A liver transplant removes a diseased or damaged liver and replaces it with a healthy one from a donor.

Normal vs. Diseased Liver
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Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

A liver transplant is done to treat a liver that is not working and cannot be treated. This may be caused by problems such as:

  • Cirrhosis
  • Hepatitis A (rare), B, or C (will become less common since this is now curable)
  • Alcoholic liver disease
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis—a problem with the bile ducts
  • Sudden liver failure
  • Biliary atresia (in children)
  • Liver tumors
  • Metabolic defects such as Wilson disease
  • Poisoning or drug-induced damage
  • Death

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Damage to nearby organs
  • Rejection of the new liver
  • Bile-duct obstruction or bile leakage into the body

Things that may raise the risk of problems are:

Lifelong medicine will be needed to suppress the immune system to lower the risk of the body rejecting the liver. This can lead to problems, such as:

What to Expect

Prior to Procedure

A healthy family member can donate part of a liver. If that is not an option, you may be on a transplant list for some time. You may need to carry a cell phone with you at all times. This will allow the transplant team to reach you if a liver becomes available.

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging a ride to and from surgery
  • Specialists you may need to see
  • Tests that will need to be done before surgery, such as imaging and heart function tests

Anesthesia

General anesthesia will be used. You will be asleep.

Description of the Procedure

A cut will be made on the upper part of the belly. The damaged liver will be removed. Some major blood vessels will be left in place. The new liver will be inserted and attached to the blood vessels and bile ducts. To help with bile drainage, a tube will also be inserted into the bile duct during surgery. The area will be closed with stitches. A bandage will be put in place.

How Long Will It Take?

Recovery will start in the intensive care unit (ICU). Staff will make sure the liver is working well.

Several hours

Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and swelling are common in the first few weeks. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is several weeks. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

After the procedure, the staff may:

  • Give you pain medicine
  • Start you on medicine to suppress the immune system to lower the risk of the body rejecting the new kidney
  • Test your liver function
  • Have you wear special stockings to promote blood flow and lower the risk of blood clots

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your cuts covered

During your stay, you can also take steps to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your cuts
At Home

It will take a few weeks for the cut to fully heal. Full recovery will take about two to four months. Physical activity will be limited during this time. You will need to ask for help with daily activities and delay your return to work.

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excessive bleeding, or discharge from the cut
  • Pain that you cannot control with medicine
  • Nausea and vomiting
  • Cough, shortness of breath, or chest pain
  • Black or tarry stools (poop), loose stools, or problems passing stool
  • Pain, burning, or blood in the urine
  • Problems passing urine
  • Lightheadedness or loss of consciousness
  • Pain or swelling in the feet, calves, or legs
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES

American Liver Foundation  https://www.liverfoundation.org 

United Network for Organ Sharing  https://www.transplantliving.org 

CANADIAN RESOURCES

Canadian Liver Foundation  https://www.liver.ca 

Health Canada  https://www.canada.ca 

References

Acute liver failure. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-liver-failure. Accessed April 12, 2022.

Liver transplant. American Liver Foundation website. Available at: https://liverfoundation.org/for-patients/about-the-liver/liver-transplant. Accessed April 12, 2022.

Liver transplant. National Institute of Diabetes and Digestive and Kidney Disorders website. Available at: https://www.niddk.nih.gov/health-information/liver-disease/liver-transplant. Accessed April 12, 2022.

Revision Information