Your Liver Transplant: The Procedure

A liver transplant is major surgery. During a liver transplant, your diseased or injured liver is removed. It’s replaced with a healthy donor liver. Most transplanted livers are still working well many years after surgery. This sheet tells you more about what to expect.

Before transplant surgery

If you've been on a waiting list, you'll get a call from the transplant coordinator once a donor liver is found. When you arrive at the transplant center or hospital, your health and condition will be checked. You and the donated liver will be tested before surgery. This is to make sure that:

  • Your body is healthy enough for surgery

  • The donated liver matches your blood type

  • The donated liver is the right size for your body

Some things could make your doctor postpone the surgery. These include a current or recent illness, changes in the health of your liver, or problems with the new liver. This can be frustrating. Try to remember that the doctors are making the best decision for your health.

During transplant surgery

A liver transplant can take  4 to 12 hours. You'll be given medicine that prevents pain and makes you sleep during surgery (general anesthesia). The diseased liver is taken out of your body and replaced with the new liver. The blood vessels and bile ducts are then attached to the new liver. Your gallbladder is also removed.

After surgery

You'll stay in the hospital for 1 to 2 weeks or longer. You may be in the ICU (intensive care unit) for a short time after surgery. During this time, you may be on a machine to help you breathe (a ventilator). Skilled nurses and doctors will closely watch your health and liver function. As you heal, you'll have tests to see if the new liver is working right. These may include ultrasound tests, a liver biopsy, and blood tests. You'll learn about your medicines and how to care for yourself when you go home. In some cases, your doctor will do a “second look” surgery before sending you home.

Caring for yourself at home

Your healthcare provider will give you instructions on how to care for yourself and your new liver. You'll need to see your provider a lot. This is so they can check for signs of a problem. Problems to watch for include:

  • Infection

  • Complications from the surgery

  • Reactions to the medicines

  • Organ rejection

  • The original liver disease comes back

  • New conditions occur from the medicines, such as diabetes, high blood pressure, or high cholesterol

It's important to not drink alcohol after a liver transplant.

What is organ rejection?

Your body's immune system fights germs. It also protects against foreign materials that may enter your body and cause an infection. When an organ is transplanted, your immune system thinks the new organ is a foreign material and starts to fight the new organ. This process is called rejection.

Antirejection medicine prevents the immune system from fighting the organ. You'll need to take these medicines for the rest of your life. Talk to your healthcare provider about the benefits and risks of taking these medicines. Be sure that all of your other doctors and healthcare providers know that you're taking antirejection medicine.

When to call your healthcare provider:

Call your healthcare provider right away if any of these occur:

  • Fever of  100.4° F ( 38.0°C) or higher, or as directed by your provider

  • Shaking chills

  • Vomiting or diarrhea for  24 hours or longer

  • A lasting cough, or coughing up green or yellow mucus

  • New or increasing swelling in your hands, arms, feet, ankles, belly (abdomen), or face

  • Bleeding from your nose, mouth, or rectum

  • Bloody stools or pee

  • Black and tarry stool

  • Bruising more easily than normal

  • A new or severe headache

  • Can’t take your prescribed medicine

  • Signs of organ rejection:

    • Abnormal tiredness or loss of appetite

    • Orange or brown-colored pee

    • Pale or clay-colored stools

    • Fever

    • Belly feels sore

    • Belly or liver pain

    • Yellowish color to your skin or eyes (jaundice)

Online Medical Reviewer: Jen Lehrer MD
Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Raymond Turley Jr PA-C
Date Last Reviewed: 10/1/2021
© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.