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Life After a Liver Transplant

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What to Expect and How to Stay Healthy After a Transplant

Posted by Lee F. Peng, MD, PhD

For patients with chronic liver failure, preparing for a transplant can be a stressful but exciting time. A new liver can offer the opportunity for a longer, healthier life. Part of my job as a hepatologist (liver specialist) with the Temple Liver Transplant team is helping those who are on the list for a donor organ — or who have recently received one — adjust to life after a liver transplant.

That means taking time to answer questions about transplant recovery and how patients can take steps to help ensure the best possible outcome. Here are some of the things patients and their loved ones commonly ask during our visits.

How long will it take before I feel like myself again after my transplant?

It typically takes between 6 to 12 months to get back to normal or near-normal activities after a liver transplant. That said, this time frame isn’t one size fits all. The healthier you were before your transplant, the sooner you’ll recover afterward.

Patients should expect to spend the first several weeks post-transplant in the hospital due to the complexity of this major surgery, but hospitalization times can be shorter, depending upon the patient. Throughout the recovery period and beyond, you will also need regular blood work. These labs are critical for showing how the body is responding to the new liver. You will always need these tests, but they’ll become less frequent over time.

How can I lower my risk of organ rejection after a liver transplant?

Every person who receives a donor liver faces the risk that their body will reject it. When a new organ is transplanted into a patient’s body, the immune system sees the new organ as an invader, much like it views an infection. If the immune system begins to attack the new organ, the new organ is being rejected. This can send you into organ failure and potentially put your life at risk.

However, anti-rejection medications can manage this threat. These drugs suppress the immune system to stop it from attacking and destroying your new liver. For anti-rejection drugs to be effective, you need to take them every day, exactly as prescribed, for the rest of your life.

You can take other steps to make sure your anti-rejection medications do their job as effectively as possible. I recommend that you:

  • Go to all of your scheduled blood work appointments. Sometimes blood work can show signs of organ rejection before you notice symptoms, and your anti-rejection medications can be adjusted as needed.
  • Tell your doctor about any other medicines, vitamins, or supplements you’re taking. Some may reduce the effectiveness of your anti-rejection medications.
  • Avoid eating grapefruit and drinking grapefruit juice. They can negatively interact with your anti-rejection medicine.
  • Let your doctor know if your anti-rejection medication is causing unpleasant side effects like headaches or diarrhea, but do not make a change to your medication routine unless your doctor approves.

How can I take care of myself and my new liver?

Living a healthy lifestyle will help you feel your best and promote healthy liver function. People who have received a donor liver should:

  • Eat a nutritious diet. A liver-friendly diet is low in salt, cholesterol, fat, and sugar. Choose fruits and vegetables, high-fiber foods, lean meat (like skinless chicken), and fish. Drink plenty of water too.
  • Avoid alcohol. Alcohol can damage your new liver. Don’t drink it or use it in cooking.
  • Be active. Exercise will help you feel good physically and mentally. Start out by walking as soon as your doctor gives you permission to do so after surgery.
  • Reduce your exposure to germs. Because anti-rejection medications suppress the immune system, people who have had transplants are at higher risk for getting sick. Do your best to stay away from people who have contagious illnesses like colds or the flu.
  • Stay up-to-date on your vaccinations. Vaccinations can help reduce your chance for serious illnesses. However, people who have received transplants should generally avoid “live” vaccines, such as the chickenpox vaccine, since those vaccines may actually cause the disease they are supposed to prevent. Check with your doctor to see which vaccines are safe for you.
  • Undergo regular cancer screenings. Long-term use of immunosuppressant medications increases your risk of developing skin cancer and other cancers. Talk with your doctor to determine which screenings are appropriate for you.
  • Talk with your care team before traveling. Start the conversation at least 2 months ahead of a trip to allow yourself time to take any appropriate precautions. If you’re planning to go to a developing country, you may need to be careful about things like the food you eat and the water you drink.

View infographic on how to stay healthy after a liver transplant >

What are the signs of possible organ rejection?

The risk of organ rejection is highest 3 to 6 months after receiving a new liver. If your body is rejecting its new liver, you might notice symptoms like:

  • Feeling tired
  • Pain or tenderness in your abdomen
  • Fever
  • Yellowing of your skin or whites of your eyes
  • Dark-colored urine
  • Light-colored stools

Remember, rejection doesn’t always cause noticeable symptoms — it may only show up in bloodwork. That is the main reason why you must follow your schedule for routine lab appointments.

When should I call the doctor if I’m not feeling well?

You should call your doctor right away any time you experience these possible symptoms of rejection. You should also let your doctor know if you have signs of a possible infection — including chills, a stuffy nose, a cough or sore throat, vomiting, or diarrhea. Based on your symptoms, your doctor can determine if a biopsy is needed to see if your body is rejecting your donor liver.

Protecting your liver after a transplant might feel a little overwhelming at first. If a patient needs some encouragement, I tell them this: When you follow these recommended post-transplant habits, the odds of going on to live a healthy life are in your favor.

Team up with Temple Health

Our highly experienced organ transplant team at Temple Health helps patients successfully navigate every step of the transplant journey — from getting on an organ transplant list and having surgery to living life to the fullest after a transplant.


Liver transplant infographic

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