Life after Transplant

Concerns after Liver Transplant Surgery

 

There are many new things a person experiences after liver transplantation. Before you leave the hospital, our team will provide all the instructions you and your family will need to take care of you. Three to four months after the operation, most patients have recovered fully, returned to work, and are enjoying active lives. Our goal is to provide expert care and excellent follow-up, so to make the extent and quality of your life appreciably better than before. We urge you to always keep in touch with us as well as with your local doctor for your ongoing care.

How long will my new liver last ?
Liver transplant can have excellent outcomes. Recipients have been known to a normal life over 30 years after the operation. On an average 90% of patients are doing well after one year of transplant. About 75% are doing well at 5 years after transplant. The outcome of transplant is dependent on many factors such as the cause of your primary liver disease, age, associated illnesses, and severity of illness at the time of transplant.

Transplant recipients directly contribute to the success of their transplant. Failure to comply with the medications (immunosuppressants) is the number one cause of failure of the transplanted liver. Close follow-up with the transplant team and your primary doctor can help ensure a good outcome. Careful attention to medication schedules, lifestyle changes, and avoidance of infection are all important ways to prolong one’s life after transplantation.

What will be my quality of life after liver transplantation ?
The first 2-3 months following transplantation are the most difficult. By the time of discharge from the hospital patients are able to care for themselves, with some minor restrictions. Our team will prepare you well before discharge so that you can take your medications and take care of yourself at home.  Our social worker, nutritionist and physiotherapist will teach you about diet, exercise and other general activities. Most patients can return to work within 3 to 6 months after a transplant. Playing sports, performing healthy exercise, socializing, and traveling for business and pleasure are all possible. We always hope that most of our patients who undergo liver transplantation can lead “normal” lives.

We have a Transplant support group that meets once every month. It is attended by patients who have had organ transplants. After your transplant, this group is an excellent means of support and information. You can interact with other patients and share their problems. We urge you to attend these meetings. It is organized by our Social worker.

Can my liver disease come back after transplant ?
Certain liver diseases, like hepatitis C and autoimmune liver disease can reappear in the new liver. We will advise you on the incidence of recurrence of specific liver diseases. We will monitor you very closely to help prevent recurrence.

How much pain will occur after the surgery ?
There is pain after liver transplant surgery, however it is generally not as severe as with other abdominal surgeries. Pain is generally tolerable and may last up to one week. You will receive adequate pain relief after surgery so as to make you comfortable. You may experience some numbness around the scar site. This is because nerves are cut during the initial abdominal incision. These nerves usually regenerate over a period of 3 to 6 months and sensations return.

What medications do I need after my transplant ?
Patients must take several medications after a liver transplant. There are medicines to prevent rejection (immunosuppressants), to prevent infection (antibiotics), and vitamin and mineral supplements. if you have preexisting diseases such as diabetes, high blood pressure, you will need medications for these diseases as well. At discharge, approximately 7 to 10 different type of medicines may be prescribed. The number of medicines are reduced over time. By 6 to 12 months, most patients are taking only 2 to 3 medicines. It is important to remember that immunosuppressants are required for the rest of the life. if you miss your medicine, alter the dose or stop taking the medicine, it can lead to rejection and failure of the liver.

What side effects can occur due to medications prescribed after transplant ?
Medications do have side effects. Typical side effects are high blood pressure, diabetes, mood changes, bone and muscle weakness, kidney dysfunction, nausea, vomiting, diarrhea, and headache. Most patients will experience some side effects initially, but these often diminish over time as dose of medicines are reduced. When side effects are severe, the medicines can often be adjusted or changed to improve tolerance.

Can I return to work after my transplant ?
Yes, patients are encouraged to return to work after transplantation. It customarily takes around 3 months before returning to work is feasible. Initially light work may be recommended. From the start of the transplant process, we encourage our patients to consider their long-term employment goals so that they can rejoin work in a timely manner.

Can I drink alcohol after my transplant ?
No. Alcohol toxic to the liver. We advice our patients not to drink even a small amount of alcohol. Alcohol can interfere with the metabolism of certain medications. We advise our patients not to smoke as well.

Can I have sex after my liver transplant ?
Yes. Sexual activity can resume early after discharge from the hospital. Because of illness, many patients experience lack of sexual desire prior to transplant. This usually gets better after transplant. We encourage patients to be in a long-term monogamous relationship. Birth-control methods should be discussed with your transplant team and implemented when sexual activity resumes.

Will I be able to have children after my transplant ?
Many couples are able to have children after liver transplantation with minimal risk to the mother and baby. Women are advised to wait at least one year following transplantation before trying to conceive. It is important to discuss such plans with the transplant team. They will need to carefully evaluate the health and medication regimen of women who wish to become pregnant. Planning the pregnancy and receiving close follow-up care throughout is very important.

Can I get in touch with the family of my donor ?
Transplant recipients often want to thank the donor’s family. Direct interaction is not encouraged. You can however write a letter and give it to our Social worker who will forward it to the donor family via the organ procurement agency.