After surgery, you will go directly to the intensive care unit (ICU), usually for a short stay. During surgery, a breathing tube will be inserted to help you breathe. In most cases the tube can be removed shortly after surgery. Many monitoring lines also will be attached; these, too, will be removed as you become more stable. When you are ready to leave the ICU, you will be cared for on the transplant unit of the hospital.
Everyone recuperates from liver transplantation differently. Depending on your condition, you will likely be hospitalized five to ten days following the transplant. Your length of stay is personalized based on a number of factors including how sick you are at the time of transplant, complexity of the operation, and post-transplant complications. You are expected to have a caregiver available both during your time in the hospital to learn your transplant medicine and after discharge until you recover.
After the Hospital
After you are discharged from the hospital, you will be seen in the liver transplant clinic at UCSF Parnassus weekly, and as you recover, your visits will become less frequent.
If you are not from the San Francisco area, you probably will need to stay close by for the first month after discharge. Laboratory blood tests are obtained twice a week following transplantation. Gradually, the frequency of blood tests will be reduced.
You will be notified about any adjustments in your medications. Complications can occur with any surgery. Patients undergoing organ transplantation may face additional complications. The life-threatening disease that created the need for your transplant may affect other body systems. Other risks, such as rejection, also may occur.
Some possible transplant complications and medication side effects include:
- HemorrhageOne function of the liver is to manufacture clotting factors which help stop bleeding. When a liver fails, the ability to produce clotting factors is impaired. To correct this problem, you will receive blood products before and after surgery. It is expected that your new liver will start working very quickly to help prevent any excessive bleeding, but it is possible that you may be returned to surgery to control the bleeding, particularly if it occurs within the first 48 hours after transplant.
- ThrombosisThis is a serious complication that may require a second transplant. If a blood clot forms in a vessel leading to or from your liver, this may injure your new liver. You may receive special anticoagulation medication to prevent thrombosis.
- RejectionYour body's defense system, the immune system, protects you from invading organisms. Unfortunately, it also views your new liver as foreign and will try to destroy it in an attempt to protect you. This is known as rejection. To prevent this from occurring, you will be given special immunosuppressive medication that must be taken for the rest of your life.
- Recurrent diseaseSome liver diseases may come back after your transplant. If this is a concern, your provider will discuss this further with you.
Immunosuppressive medications, also known as anti-rejection medications, help to prevent and treat rejection. These drugs decrease your body's resistance to foreign bodies, such as your new liver. You will need to take these medications for the rest of your life or you will reject your liver. Immediately after surgery, the dosages will be high since the probability of rejection is greatest at this time. Dosages will be lowered quickly to smaller amounts if there are no signs of rejection.
These medications have side effects, some of which are dose-related. Most people experience the highest level of side effects in the beginning when medication dosages are high. As the dosage is lowered, these effects will probably lessen. Side effects may occur in some patients and not in others.
These anti-rejection medications also impair your body's ability to fight off infections. You will be given medication to help prevent infections but you also will need to use caution and avoid contact with people with infections, especially during the first three to six months after transplant.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
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