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By Mayo Clinic staff
During a liver transplant
If you're notified that a donor liver is available, you'll be asked to come to the hospital immediately. Your health care team will admit you to the hospital, and you'll undergo an exam to make sure you're healthy enough for the surgery.
Liver transplant surgery is done using general anesthesia, so you'll be unaware during the procedure. A tube is put down your throat to help you breathe. Drugs that suppress your immune system are injected into your veins to help keep your body's disease-fighting immune system from attacking the new liver.
The transplant surgeon makes a long incision across your abdomen to access your liver. The location and size of your incision varies according to your surgeon's approach and your own anatomy.
The surgeon disconnects your liver's blood supply and the bile ducts and then removes the diseased liver. The donor liver is then placed in your body and blood vessels and bile ducts are reattached. Surgery can take four to 14 hours, depending on your situation.
Once your new liver is in place, the surgeon uses stitches and staples to close the surgical incision. You're then taken to the intensive care unit to begin recovery.
Liver transplant using a living donor
If you're receiving a liver transplant from a living donor, such as a friend or family member, surgeons will transplant a portion of the donor's liver in your body. Surgeons first operate on the donor, removing one portion of the liver for transplant. Then surgeons remove your diseased liver and place the donated liver portion in your body. They then connect your blood vessels and bile ducts to the new liver.
The transplanted liver portion in your body and the portion left behind in the donor's body regenerate rapidly. Within a week, your new liver grows to 85 percent of its original size. Regeneration continues for several months.
After a liver transplant
After your liver transplant, you can expect to:
- Stay in the intensive care unit for a few days. Doctors and nurses will monitor your condition to watch for signs of complications. They'll also test your liver function frequently for signs that your new liver is working.
- Spend 1 to 3 weeks in the hospital. Once you're stable, you're taken to a transplant recovery area to continue recuperating.
- Have frequent checkups as you continue recovering at home. Your transplant team designs a checkup schedule for you. For instance, you may need your blood drawn three times a week for blood tests and to meet with your doctor weekly. For the first several weeks you may need someone to drive you to appointments.
- Take medications for the rest of your life. You'll take a number of medications after your liver transplant, many for the rest of your life. Drugs called immunosuppressants help keep your immune system from attacking your new liver. Other drugs help reduce the risk of other complications after your transplant.
- Rudow DL, et al. Critical care management of the liver transplant recipient. Critical Care Nursing Quarterly. 2008;31:232.
- Liver transplant. American Liver Foundation. http://www.liverfoundation.org/education/info/transplant/. Accessed Oct. 21, 2008.
- What I need to know about liver transplantation. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.nddk.nih.gov/ddiseases/pubs/livertransplant_ez/. Accessed Oct. 21, 2008.
- Koffron A, et al. Liver transplantation: Indications, pretransplant evaluation, surgery, and posttransplant complications. The Medical Clinics of North America. 2008;92:861.
- Arora G, et al. Management of chronic liver failure until liver transplantation. The Medical Clinics of North America. 2008;92:839.
- Brown RS. Live donors in liver transplantation. Gastroenterology. 2008;134:1802.
- O'Leary JG, et al. Indications for liver transplant. Gastroenterology. 2008;134:1764.
- Removal reasons by year. Organ Procurement and Transplantation Network. http://www.optn.org/data/. Accessed Oct. 23, 2008.
- Transplants by donor type. Organ Procurement and Transplantation Network. http://www.optn.org/data/. Accessed Oct. 23, 2008.
- Liver Kaplan-Meier patient survival rates for transplants performed: 1997-2004. Organ Procurement and Transplantation Network. http://www.optn.org/data/. Accessed Oct. 23, 2008.
