Liver Transplant

Surgery Overview

A liver transplant is surgery to give you a healthy liver from another person. You may get a whole new liver or just part of a new liver. A whole liver comes from a person who is deceased. If you get a part of a liver from a live donor, the parts will grow back to full size in you and in the donor.

Before the transplant, you'll have tests to see how well the donor liver matches your tissue type and blood type.

Choosing a transplant center

Your doctor can refer you to an organ transplant center. You can get information about different centers and talk with your doctor about your best option. When choosing a transplant center, consider things like cost and payment options, location and travel, family support, and what types of organ transplants are offered. Learn as much as you can about each center.

How It Is Done

To do the surgery, the doctor makes a cut (incision) in your upper belly. Then the doctor removes your liver. Next, the blood vessels of the new liver are connected to your blood vessels. The bile duct of the new liver is connected to your bile duct or intestine. The doctor finishes the surgery by closing your incision with stitches or staples. The stitches will dissolve inside your body. The staples will be removed a few weeks after surgery. The incision will leave a scar that will fade with time.

What to Expect

You will be cared for in the intensive care unit (ICU) for a couple of days after surgery. Then you will probably spend 1 to 2 weeks in the hospital. Most people are able to go back to work in a couple of months. But it depends on the type of work you do and how you feel. It may take 2 to 4 months for your energy to fully return.

After surgery, the new liver should start to do the work that your diseased liver could not.

After the transplant, you will take medicine to keep your body from rejecting the new liver. You will most likely need to take this anti-rejection medicine every day for the rest of your life. These medicines have side effects. One side effect is that your body may be less able to fight infections.

It's important to take steps to avoid infections from now on. Be careful in public places and crowds of people. Stay away from anyone who might have an infection or an illness such as a cold or the flu. You may have to call your doctor anytime you have a fever.

Getting support

Having good support is important throughout the process of getting a transplant. Waiting for your transplant can be hard emotionally. After your surgery, you may have concerns about your health and the new organ you received. You'll also have a lot to manage, like taking new medicines and going to follow-up visits.

Getting support from others, such as friends and family, can help during this time. A counselor can help you learn to cope with stress and other emotions before and after your surgery.

Many people who have an organ transplant feel anxious or depressed. Talk to your doctor if you think you may be depressed. Depression can be treated with medicines and counseling.

Why It Is Done

You may need a transplant if your liver doesn't work as it should. Slowly over time, the liver may stop working (chronic liver disease). Normal liver tissue may be replaced by scar tissue. This is called cirrhosis. It may be caused by things such as hepatitis, long term alcohol use, or fatty liver disease.

Sometimes the liver suddenly stops working (acute liver disease). This can happen because of an infection like hepatitis or other viruses, an injury, or an overdose of acetaminophen (Tylenol).

A transplant may also be done for liver cancers.

How Well It Works

Most people can have a good quality of life after their transplant. The success of a liver transplant may depend on:

• Going to all follow-up appointments, getting all your tests, and calling your doctor if you have problems.
• Your overall health. After the transplant, it's important to keep a healthy lifestyle. This includes eating healthy foods and being active. Don't drink alcohol or smoke.
• Whether you take your medicines as prescribed. Most people take anti-rejection medicines every day for the rest of their lives.
• Finding and treating organ rejection early. This makes it more likely that your transplanted liver will stay healthy. That's why it's important to go to follow-up appointments and get tests.
• The disease that caused your liver to fail.

Risks

Like any surgery, a liver transplant has some risks. Risks include:

• Organ rejection. The body sees the new liver as foreign and tries to destroy it. This happens because the donor liver doesn't match the body's tissue exactly.
• Problems such as bleeding during and after the surgery.
• Infection. The medicines that help fight organ rejection can also make it harder for the body to fight infection.
• Certain cancers, such as skin cancer. This risk increases because anti-rejection medicines can also prevent the body from attacking cancer cells.