Post Operative Care

After surgery, the liver transplant recipients are taken directly to the Surgical Intensive Care Unit. The average length of stay in the Intensive Care Unit is 2-5 days. During this time, you will be monitored closely and will also have many tubes. In the first 2 postoperative days, many of the tubes will be removed. When your condition stabilizes, you will be transferred to either Ward 6A or 6B.

Once in the ward, visiting hours are less restrictive and there is more privacy. The average hospital stay is approximately 2 weeks after liver transplant. Patients who are more ill going into surgery, can expect to have a longer recovery period and hospital stay. Maintaining activity and adequate nutrition while waiting for transplant is important for your recovery. While recovering, you will spend time learning how to care for yourself after transplant. We will begin by having you take your own medications as soon as you have recovered enough to do so.

Re-operations following liver transplants are common. Most are short operations. The most common indication for re-operation is bleeding and this usually occurs in the first 2-3 days after the transplant. Bile leaks and infections of the abdomen can also occur, usually about one week after the transplant. Some livers may fail to function properly and need to be replaced with another new liver. When repeat transplant is necessary, the operation is generally much shorter in length.

Two types of problems may develop in the early post-operative period. The first is ischemic injury, which can occur during the recovery and preservation of the donor liver. Signs of this usually develop in the first 7 days post-transplant. A more frequent occurrence is rejection. Rejection can occur at any time after transplant.

Approximately 90% of patients who undergo organ transplant will develop some degree of rejection. Rejection can be diagnosed by review of lab results or by liver biopsy. Once rejection occurs, it can usually be reversed with several high doses of steroids. If the rejection is not reversed with steroids, other rnedications can be used. It is important to know that rejection happens frequently and that in most cases it can be reversed.

The Recovery Process and Follow Up After Discharge

You should anticipate being out of work for 6 to 8 weeks after your surgery to allow your body time to continue healing itself properly. This will depend on your individual recovery as well as the type of work you do. Lifting will be restricted to no more that 10 pounds for the first two weeks following surgery, and then can gradually be increased as you heal. Walking will be advised and you will be encouraged to slowly increase the amount of walking each week.

You will need to come back to the Transplant Clinic approximately 1 week after your discharge for a physical exam and blood work to monitor how your body is adjusting after the surgery. Because of its amazing capacity to regenerate, the liver is restored to its original size in the donor, and grows to a comparable size in the recipient, in approximately 12 weeks.

You should notify each of your local health care providers of any problems that develop once you are discharged home, and they should be given the number to the Transplant Office in the event they need to contact us to discuss a problem related to your surgery.