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Preparation 

When selected as the recipient for a new liver, the patient will be called and must come to the hospital right away. As soon as the patient arrives he or she will be admitted to the transplant floor. The coordinator will provide the patient with exact instructions. The patient will have a brief exam, blood and urine tests, x-rays and an EKG. He or she will receive medications to clean out the gastrointestinal tract and the first doses of anti-rejection medication. 

Procedure 

During the transplant surgery the patient will be put under general anesthesia, which means he or she will be given drugs to sleep, block pain and paralyze parts of the body. The patient will also be placed on a machine to help the patient breathe. The transplant surgeon will make an incision in the abdomen. Through this incision the liver and gall bladder will be removed and a donated liver (without a gallbladder) will be placed into the abdomen.

During the surgery the patient may require veno bypass. If required, the surgeon will place incisions in the patient’s underarm or neck and groin for the placement of tubes. These tubes will connect to a machine that allows the blood to bypass the liver during surgery. The transplant surgeons will decide if this machine will be used based upon the patient’s condition.

Drains will be put into the area around the liver to allow fluids to be removed and to help in healing. Special mechanical boots will be used to keep blood flowing through the legs to prevent blood clots. The patient will be in the operating room for approximately 4 to 6 hours. 

Recovery 

After the surgery the patient will be taken to the surgical intensive care unit where he or she will be closely monitored for one to two days. Once the patient has stabilized, he or she will be transferred to the transplant floor. The length of stay in the hospital will depend on the rate of recovery, usually between seven and 14 days.

After the patient leaves the hospital, he or she will still be recovering. The patient should plan to stay near the hospital for another one to two weeks, if the patient lives more than one hour away. Since the patient may not be strong enough to stay alone and may need help with certain activities, a family member or friend will need to stay as well.

For the first four to six weeks patients will have some routine restrictions on daily activities. During the recovery period the transplant team will follow the patient’s progress closely. The patient will need to be monitored on a long-term basis and must agree to be available for exams, lab tests and scans of the abdomen to see how the transplanted liver is doing. The transplant team will also see the patient regularly for three to six months post-transplant and the patient will be followed in the transplant clinic for life.

For more information, please view the Liver Transplant Patient Manual.