Liver Transplant: About the Procedure

When selected as the recipient for a new liver, you will be called and must come to the hospital right away. Upon arrival, you will be admitted to the transplant floor and the transplant coordinator will provide you with exact instructions. You’ll have a brief exam, blood and urine tests, X-rays, and an EKG. You will also receive medications to clean out the gastrointestinal tract and the first doses of anti-rejection medication. 

Procedure 

You will be put under general anesthesia, which means you’ll be given drugs to sleep, block pain, and paralyze parts of the body, during the transplant surgery. A machine will help you 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.

You may require veno bypass. If required, the surgeon will place incisions in your 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 is needed based upon your 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 also be used to keep blood flowing through the legs and prevent blood clots. You should be in the operating room for approximately four to six hours. 

Recovery 

You will be taken to the surgical intensive care unit and closely monitored for one to two days after the surgery. Once stabilized, you will be transferred to the transplant floor. Your hospital stay will last seven to 14 days depending on how quickly you recover.

The recovery period continues after you leave the hospital. If you live more than an hour away, you should plan to stay near the hospital for another one to two weeks. Since you may not be strong enough to stay alone and may need help with certain activities, a family member or friend will need to stay with you.

You will have some routine restrictions on daily activities for the first four to six weeks. The transplant team will follow your progress closely during the recovery period. You’ll 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 you regularly for three to six months post-transplant, and you will be followed in the transplant clinic for life.