Your Liver Transplant: The Procedure

A liver transplant is major surgery. During a liver transplant, your diseased or injured liver is removed. It’s replaced with a healthy donor liver. Most transplanted livers are still working well one year after surgery. This sheet tells you more about what to expect.

Before transplant surgery

If you have been on a waiting list, you will get a call from the transplant coordinator once a donor liver is found. When you arrive at the transplant center or hospital, your health and condition will be checked. You and the donated liver will be tested before surgery. This is to make sure that:

  • Your body is healthy enough for surgery

  • The donated liver matches your blood type

  • The donated liver is the right size for your body

Some things could make your doctor postpone the surgery. These include a current or recent illness, changes in the health of your liver, or problems with the new liver. This can be frustrating. Try to remember that the doctors are making the best decision for your health.

During transplant surgery

A liver transplant can take  4 to 12 hours. You will be given medicine that prevents pain and makes you sleep during surgery (general anesthesia). The diseased liver is taken out of your body and replaced with the new liver. The blood vessels and bile ducts are then attached to the new liver.

After surgery

You will stay in the hospital for 1 to 2 weeks, or longer. You may be in the ICU (intensive care unit) for a short time after surgery. During this time, you may be on a machine to help you breathe (a ventilator). Skilled nurses and doctors will closely watch your health and liver function. As you heal, tests will be done to see if the new liver is working right. These may include ultrasound tests, a liver biopsy, and blood tests. You'll learn about your medicines and how to care for yourself when you go home. In some cases, your doctor will do a “second look” surgery before sending you home.

Caring for yourself at home

Your healthcare provider will give you instructions on how to care for yourself and your new liver. You will need to see your doctor a lot. This is so he or she can check for signs of a problem. Problems to watch for include:

  • Infection

  • Complications from the surgery

  • Reactions to the medicines

  • Organ rejection

  • Recurrence of the original liver disease

  • Development of new conditions, such as diabetes, high blood pressure, or high cholesterol, from the medicines

It's important to not drink alcohol after a liver transplant.

What is organ rejection?

Your body's immune system fights germs. It also protects against foreign materials that may enter your body and cause an infection. When an organ is transplanted, your immune system thinks the new organ is a foreign material and starts to fight the new organ. This process is called rejection.

Antirejection medicine prevents the immune system from fighting the organ. You will need to take these medicines for the rest of your life. Talk to your healthcare provider about the benefits and risks of taking these medicines. Be sure that all of your other doctors and healthcare providers know that you are taking antirejection medicine.

When to call your healthcare provider:

  • Have a fever of  100.4° F (38.0°C) or higher, or as directed by your provider

  • Vomit or have diarrhea for  24 hours or longer

  • Have a persistent cough, or cough up green or yellow mucus

  • Have new or increasing swelling in your hands, arms, feet, ankles, belly (abdomen), or face

  • Bleed from your nose, mouth, or rectum

  • Have bloody stools or urine

  • Have black and tarry stool

  • Bruise more easily than normal

  • Have a new or severe headache

  • Can’t take your prescribed medicine

  • Have signs of organ rejection:

    • Unusual tiredness or loss of appetite

    • Orange or brown-colored urine

    • Pale or clay-colored stools

    • Fever

    • Belly feels tender

    • Belly or liver pain

    • Yellowish color to your skin or eyes (jaundice)