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Liver Transplant: What to Expect at Home

Your Recovery

A liver transplant is surgery to give you a healthy liver from another person. You may have received a whole new liver or just a section of a new liver. The new liver may have come from someone you know, a stranger, or a person who has died. Your doctor will take out your diseased liver when you get a donor liver.

Your belly and side will be sore for the first 1 to 2 weeks after surgery. You also may have some numbness around the cut (incision) the doctor made. It is common to feel tired while you are healing. It may take 3 to 6 months or longer for your energy to fully return.

After the transplant, you must take medicine to keep your body from rejecting the new liver. You will need to take anti-rejection medicine every day from now on. These medicines have side effects. One side effect is that your body may be less able to fight infections. It's important to take steps to avoid infections. Stay away from crowds of people and anyone who might have an infection or an illness such as a cold or influenza (flu).

Having an organ transplant can bring up many emotions. Seek out family, friends, and counsellors for support. If you think you are depressed, ask your doctor for help. Treatment can help you feel better.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to feel better as quickly as possible.

How can you care for yourself at home?

Activity

Rest when you feel tired. Getting enough sleep will help you recover.
Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
Avoid exercises that strain your belly muscles and activities that make you work hard, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 4 to 6 weeks.
For 4 to 6 weeks, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
Ask your doctor when you can drive again.
Most people are able to return to work about 3 months after surgery. It depends on the type of work you do and how you feel.
You may take showers. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
Ask your doctor when it is okay for you to have sex.

Diet

Follow your doctor's instructions about what to eat after your surgery. You may need to follow a special diet for your liver or for other health problems.
Drink plenty of fluids (unless your doctor tells you not to).
Avoid drinking alcohol. It can damage your liver. If you misused alcohol before your transplant, counselling, support groups, and sometimes medicine can help you quit.
You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
Take your anti-rejection medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine.
Be safe with medicines. Take pain medicines exactly as directed.
- If you are not taking a prescription pain medicine, take an over-the-counter medicine that your doctor recommends. Read and follow all instructions on the label.
- Do not take aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or other non-steroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
- Do not take acetaminophen (Tylenol) or any over-the-counter medicines that have acetaminophen in them without checking with your doctor.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
If your doctor prescribed antibiotics, antiviral, or antifungal medicines, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of medicines.

Incision care

If you have strips of tape on the incision, leave the tape on until it falls off.
If the incision is closed with staples, the staples will be removed a few weeks after surgery.
Gently wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it oozes or rubs against clothing.
Change the bandage every day or if it gets wet or dirty.
Keep the area clean and dry.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have trouble breathing.
You have sudden chest pain and shortness of breath, or you cough up blood.
You have severe pain in your belly.

Call your doctor or nurse advice line now or seek immediate medical care if:

You have pain that does not get better after you take pain medicine.
You are sick to your stomach or vomiting or cannot keep down fluids or your anti-rejection medicines.
You have a fever, chills, or body aches.
You have loose stitches, or your incision comes open.
You are bleeding through the bandage.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
Your body shows signs of rejecting the new liver, such as:
- Pain or swelling in the belly.
- Sudden weight gain.
- Yellow colour of the skin or whites of the eyes.
- Dark urine.
- Headache, crankiness, or lack of energy.
- Light-coloured or bloody stools.
You have trouble passing urine or stool, especially if you have pain or swelling in your lower belly.
You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
- Pain in the calf, back of the knee, thigh, or groin.
- Swelling in the leg or groin.
- A colour change on the leg or groin. The skin may be reddish or purplish, depending on your usual skin colour.
You have any problems with your anti-rejection medicine.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have questions.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.