Liver Transplant Surgery 
 
 
 
 
 

 

The operation has three major parts.  First is the procurement of a donor liver.  Second is the removal of the recipient’s own liver.  The third part of the operation is the placement of the new liver.

Under general anesthesia, an incision is made on the upper part of the recipient’s abdomen. The surgical team removes the patient’s old liver, leaving portions of the major blood vessels in place.  The surgeons then insert the new liver and attach it to these blood vessels and to the patient’s bile ducts.  The operation usually takes eight hours. 

After the Surgery 

After surgery, patients will be transferred to a specialized floor with expertise in managing patients post transplant. The patient is usually out of bed and walking within two to four days after surgery and is eating a normal diet within three to four days.

Drugs to control rejection start immediately. During the hospital stay, patients are taught about the anti-rejection medications and become knowledgeable about the warning signs of rejection. To benefit our patients, all immunosuppression therapy is customized and minimized post transplant. As soon as the patient is able, the transplant team will begin to prepare him or her for going home, usually in seven days.

Patients are monitored very closely by the Hahnemann University Hospital Transplant Team for years after surgery.  Organ recipients must return for appointments once a week for the first one to two months following surgery and less frequently after that. During the visits, blood tests are performed to detect early signs of rejection and any side effects from medication are addressed.

The Transplant Center follows patients routinely, working in collaboration with the patient’s primary hepatologist and family physician as appropriate.     

Recovery at Home 

Monitoring Health

After discharge from the hospital, the patient may be asked to monitor:

  • Temperature.  Any time the patient feels chilled, hot, achy or ill, body temperature should be checked and recorded.  This may indicate infection. If the patient’s temperature is higher than normal at any time, the transplant coordinator should be notified immediately. 
  • Blood pressure. A nurse or transplant coordinator will show the patient how to measure blood pressure.
  • Pulse.  If the patient is taking medication that affects heart rate, the nurse or transplant coordinator will show how to check the pulse at home.
  • Weight.  The patient should get weighed on a standard bathroom scale at the same time every morning (after using the toilet).  A weight gain of more than two pounds per day may indicate that the patient is retaining fluid. This should be reported to the transplant coordinator. 

Guarding Against Infection 

Rejection is a complication that may occur after a transplant because the body’s immune system guards against attack by any foreign matter.  The immune system identifies a liver transplanted from another person as “foreign” and goes on the defensive to battle this invader.  To prevent this from happening, transplant patients need to take immunosuppressive medications every day.

Regular visits to the Transplant Team at Hahnemann will ensure early detection and treatment of rejection. 

Preventing Infection

Since immunosuppressive medications interfere with the body’s natural immune system, it is essential for liver transplant patients to be vigilant in guarding against infection.  These precautions are vitally important:

  • Wash hands often with soap and water or an antibacterial handwash.
  • Keep hands away from face and mouth.
  • Stay away from people with colds or other infections.
  • Wash hands after coughing or sneezing, and dispose of tissues immediately.
  • If someone in the patient’s family becomes ill with a cold of flu, be sure that individual takes normal precautions (use separate drinking glasses, cover mouth when coughing, etc.).
  • Avoid working in the soil for six months after the transplant. After that, wear gloves.
  • Avoid handling animal waste and avoid contact with animals who roam outside. Do not clean bird cages, fish or turtle tanks, or cat litter.   If a cat litter box needs to be changed, someone other than the patient should cover it and take it out of the patient’s home before changing it.
  • Avoid vaccines that involve live viruses, such as oral polio, measles, mumps, German measles, yellow fever, or smallpox. The live virus can cause infections. If a patient or any family services. member intends to receive any vaccinations, they should notify the transplant team or local physician.
  • Maintain good dental hygiene by brushing your teeth twice daily and seeing the dentist twice a year for cleaning and checkup.       

Keeping the Patient's Healthcare Team Informed

Communications and cooperation between the transplant team, local family physician, pharmacist, dentist and the patient is essential. The patient must be sure that each health care provider knows about the transplant, daily medications taken, and the precautions that must be followed to ensure the patient’s health.   

Coping with Emotions

Hahnemann offers counseling services to help patients cope with stressful feelings, adjust to life at home and prepare for return to work or school.  The transplant coordinator or social worker can provide information regarding these services.  

 
 
 
 
 

Hahnemann University Hospital | 230 N Broad St, Philadelphia, PA 19102