One of the most exciting calls you can receive while on the waiting list is when the hospital tells you that a liver has become available. This call can come at any time of day or night, and on any day of the week. It is important for you to remain reachable at all times – at work, at home or even on vacation. We recommend that you give the transplant team the phone numbers of close friends and family as well in case you cannot be reached directly. Lahey has 60 minutes to reach you before the liver is made available to the next person on the list.
Liver Transplant Preparation
It is impossible to predict when a liver will become available – so we recommend that you are always prepared to come to the hospital. An overnight bag should always be ready with clothes and items you will need in the hospital. We also recommend that you arrange a transportation plan with family and/or friends.
You will receive instructions from the surgeon regarding the specifics concerning travel to Lahey. Frequently, you will be asked to come in immediately after the phone call. Deceased donor livers will not survive for longer than 12 hours without a blood supply, and the faster it is transplanted into a recipient, the higher the likelihood the transplant will be successful.
If you are unable to reach Lahey within 4 to 6 hours of being called, the liver will be offered to the next person on the waiting list. Should this occur, your position of the waiting list will not be affected.
There is a 1 in 4 chance that the liver will be found to be unsuitable for transplantation when it arrives. This may be due to deterioration during transportation, or it may have been found to have a disease or infection. If this happens, you will be sent home to wait for the next liver. Your position of the waiting list will not be affected.
At the Hospital
At the hospital, your family will be allowed to accompany you in the pre-op area where you will undergo a few preliminary tests to ensure that you are still in good condition to receive the transplant. You will be allowed to spend some time with your family before being transferred to the operating room.
You will be brought into the operating room on a gurney, where the anesthesiologists will place you under general anesthesia. Once you are asleep, the team will insert a tube in your throat that is connected to a machine that will help you breathe (a ventilator). They will also insert a tube (a Foley catheter) into your urethra and into your bladder to allow urine to drain during the long surgery and a nasogastric tube through your nose to drain the contents of your stomach.
Your surgical transplant team will consist of two or more surgeons, two anesthesiologists, and up to four supporting nurses. The surgery can last from 4 to 10 hours, depending on the difficulty of the procedure.
You will have either an L-shaped or a Y-shaped incision on your abdomen that will be closed with staples. You will also have at least 2 drains in the surgical area to allow the fluids that accumulate during recovery to be drained.
Your Hospital Discharge
You will typically be discharged from the hospital about 7 to 10 days after your surgery. You must meet certain criteria prior to discharge including:
- You must be able to get out of bed, walk, eat, and shower on your own
- You must demonstrate understanding of your medication regimen
- Your incisions must be healing normally
- You must have an acceptable blood level of your primary immunosuppressive medication. This will usually be tacromilus (Prograf), but occasionally others are prescribed
- If you are medically but not physically ready for discharge, the transplant team may recommend additional time at a rehabilitation facility close to your home
You will have to come back to the hospital for follow-up tests frequently. If you live more than 1 hour away from Lahey, we can arrange for you to stay at a nearby hotel. This will allow for easy access to the transplant team and will avoid excessive travel.