Liver Transplant What to Expect
You’re on the transplant list, what’s next?
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From Getting Ready to Hospital Discharge: What to Know About Your Liver Transplant Operation
When you plan to have a liver transplant at Lahey Clinic, we make sure you’re prepared for what happens before, during and after your surgery.
If you have a living donor, we will schedule the date for your operation. We plan things with you ahead of time. The process is a bit different if you are waiting for a liver from a deceased donor.
Staying Prepared for Your Transplant
Once you’ve completed your evaluation and you’re on the waiting list, you may get the call that a suitable organ is available at any time. We have just 30 minutes to reach you before we make the liver available to the next person on the list. So, it’s important that you remain reachable and ready to get to us quickly.
- Make sure we know how to contact you at home, at work or while you’re on vacation.
- Provide the phone numbers of close family members and friends who may help us connect with you, if necessary.
- Pack an overnight bag with clothes and other items you’ll need at the hospital and keep it ready.
- Create a transportation plan to get you to the hospital with family and friends.
When a Liver Is Not Suitable
About 25% of the time, we’re unable to use the liver when it arrives. Infections, disease or deterioration during transplant may make it unsuitable for you. If this happens, we send you home to wait for the next liver. It doesn’t affect your position on the waiting list.
What Happens at the Hospital
When you get to the hospital, you first go to the pre-op area. There, you have tests to make sure you can receive the transplant. You’ll have time to spend with family before you go into the operating room.
More About What to Expect
When it’s time for your surgery, we move you into the operating room on a gurney. There will be surgeons, anesthesiologists and nurses waiting for you. During liver transplant surgery:
- An anesthesiologist places you under general anesthesia.
- Once you’re asleep, our team inserts a tube in your throat that connects to a machine (ventilator) that helps you breathe.
- You’ll have a tube (Foley catheter) inserted into your bladder via your urethra. The catheter allows urine to drain during the long surgery.
- You’ll have a nasogastric tube inserted through your nose to drain the contents of your stomach.
- Your surgeon will make either an L-shaped or Y-shaped incision on your abdomen.
- The surgeon removes your liver and places the donated liver in your abdomen, connecting it to blood vessels and bile ducts.
- The surgeon will place at least two drainage tubes to remove fluids that accumulate after surgery. They then close your incision with staples.
A liver transplant operation takes from four to 10 hours, depending on the difficulty of the procedure.
After your surgery, we create a long-term plan for your care. You can expect to stay in the hospital for about seven to 10 days.
We’re there to support you all the way and prepare you for life at home. We teach you about your medicines and help get you stronger. You also have access to our transplant wellness program and support group.
Your Hospital Discharge
Before discharge, you must:
- Get out of bed, walk, eat and shower on your own.
- Understand your medicines and how to take them.
- Have incisions that are healing normally.
- Have satisfactory lab and imaging results.
Once you leave the hospital, you must come back to Lahey frequently for follow-up visits. It you live more than an hour away, we can arrange for you to stay at a nearby hotel. This gives you easy access to our transplant team. We also coordinate follow-up visits with your primary care provider.
Sometimes, you’re medically ready to leave the hospital, but not physically strong enough to be on your own. In these cases, we may recommend a rehabilitation facility.
When You Get Home
When you get home, you must do muscle toning exercises. We teach you what to do before you leave the hospital. You also should walk five to 10 minutes a day. Slowly increasing the time each week will enhance your overall recovery.
You’ll have visiting nurses until you’re healthy enough to fully care for yourself. Depending on your condition, they may see you daily or three times a week. The nurses are the eyes and ears of our transplant team after your discharge. They will check:
- For signs of infection
- Your drains
- Your incisions
- Your medications
- Your vital signs
Here’s a typical recovery timeline:
- In one month: The staples are removed from your incision at the transplant center.
- In one and half months: Your bile tube is removed during a clinic visit.
- In two months: You may lift up to 15 pounds.
- In three months: You may begin jogging and resume most physical activity with some modifications.
- In three to six months: Your liver incisions will heal. You may also go back to work. If you’re still experiencing fatigue, you may wish to start off part-time.
- In one year: You may begin playing sports and weightlifting. However, you should get the transplant team’s approval before doing these activities.
When something foreign enters your body, your immune system recognizes it as a threat. Your body views your transplanted liver as a threat and will try to destroy it. This process is called rejection, and to fight against it, you must take medication called immunosuppressants. These medicines prevent your immune system from attacking your new liver.
You get your first dose at the time of your surgery. You must continue to take them as long as your transplanted liver is still working. Some of the medicines have side effects. So, you must take other medications to counteract the unwanted effects.
Our transplant nurse coordinator and transplant pharmacist will teach you all about your medications. They provide you with a card that describes:
- The medicines you must take
- Your medicine dosage and frequency
- When to take your medicine
- Side effects of your medicines
When your home nursing visits are over, correctly taking your medicines will be your responsibility. If you have any concerns or miss a dose, call our transplant office. We’re happy to help.
