This is a surgery to replace a diseased or damaged liver with a liver from a donor who has died. In some cases, a portion of the liver of a living, related donor may be used.
Normal vs. Diseased Liver
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A liver transplant is done to treat a liver that is not working and cannot be fixed. This may be caused by: Cirrhosis
CAlcoholic liver diseasePrimary biliary cirrhosisPrimary sclerosing cholangitis, which is a disease of the bile ductsSudden liver failureCongenital defects such as biliary atresiaLiver tumors
Metabolic defects such as
Wilson diseasePoisoning or drug-induced damage
If you are planning to have liver transplant, your doctor will review a list of possible complications, which may include: Rejection of the transplanted liverBleedingInfectionDamage to nearby organsBile-duct obstruction or bile leakage into the bodyComplications from immunosuppressive drugsBlood clots
Some factors that may increase the risk of complications include: SmokingObesityAlcoholismDiabetesPoor nutritionAdditional illnessesSerious heart, lung, or kidney diseaseUse of certain medicationsCancerCurrent infection
Be sure to discuss these risks with your doctor before the surgery.
There is a shortage of donors. You may be on a transplant list for some time. You may need to carry a cell phone with you at all times. This is to allow the transplant team to reach you if a liver becomes available.
Your doctor will likely do the following: Physical examBlood testsUltrasoundCT scanChest x-rayElectrocardiogram
Psychological testing and counseling—to help you to be prepared for the transplant
Leading up to your surgery:
Talk to your doctor about your medications. You may be asked to stop taking some medicines up to one week before the procedure, like:
Anti-inflammatory drugs such as ibuprofenBlood thinnersAnti-platelet medicationsTake medications as directed. Do not take over-the-counter medications without checking with your doctor.The night before, eat a light meal. Do not eat or drink anything after midnight.Arrange for someone to drive you home. Also, arrange for someone to help you at home.
If advised by your doctor, use
an enema. The enema will clean out the intestines and prevent
will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.
An incision shaped like a boomerang will be made on the upper part of the abdomen. The old liver will be removed. Portions of major blood vessels will be left in place. The new liver will be inserted and attached to the blood vessels and bile ducts. To help with bile drainage, a tube will also be inserted into the bile duct during surgery. The area will be closed with stitches.
You will be closely monitored in the intensive care unit (ICU) and will have the following devices: Breathing tube until you can breathe on your ownIV fluids and medicationBladder catheter to drain urine
Anesthesia will prevent pain during the surgery. You will have pain while recovering. Your doctor will give you pain medication.
This surgery is done in a hospital setting. The usual length of stay is several weeks. Your doctor may choose to keep you longer if you show signs of rejecting the new liver or have other problems.
While you are recovering at the hospital, you will: Receive fluids and nutrition through an IV—You will slowly transition to eating.Breathe deeply and cough 10-20 times every hour—This will help your lungs work better after surgery.Take immunosuppressive drugs—You will need to take these for the rest of your life. These drugs reduce the chance that your body will reject the new liver. They also have potential side effects, like infection and cancer. Be sure to discuss these risks with your doctor.
When you return home, do the following to help ensure a smooth recovery:
Be sure to follow your doctor’s
Take proper care of the incision site. This will help to prevent an infection.Ask your doctor about when it is safe to shower, bathe, or soak in water.Work with a physical therapist. Exercises will help you to regain strength.Monitor your temperature, blood pressure, pulse, and weight.Follow a special diet. This diet will help to prevent water retention and to maintain a normal weight and blood pressure.Take medications as advised by your doctor.
Recovery time varies. It depends, in part, on your health before the transplant.
After you leave the hospital, contact your doctor if any of the following occurs: Signs of infection, including fever and chills—you are at increased risk for infection because of the immunosuppressive drugsRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision siteCough, shortness of breath, or chest painSevere nausea or vomiting
Black or tarry stools, constipation, or
that does not go away after two loose stools
You are unable to take your medicationsBruisingRed or rusty-brown urineAny skin rash or sores in your mouthVaginal discharge in womenPain, burning, urgency, frequency of urination, or persistent bleeding in the urine
infections, such as
shinglesHeadache, confusion, lightheadedness, or loss of consciousnessUnusual weaknessIllness that requires emergency room treatment or hospitalization
In case of an emergency, call for medical help right away.
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Postgrad Med J.
Liu CL, Fan ST. Adult-to-adult live-donor liver transplantation: the current status.
J Hepatobiliary Pancreat Surg.
Neuberger J. Developments in liver transplantation.
O’Grady JG. Liver tansplantation alcohol related liver disease: (deliberately) stirring a hornet’s nest!
Last reviewed September 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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