Success of Liver Transplantation, post-transplant Dos and Don’ts

Table of Content

Liver failure is a situation where the liver has lost almost all its functionality, due to one or more reasons. This can be either acute, which develops over a period of a few weeks and shows severe symptoms, or chronic, which develops over a couple of years and shows moderate symptoms. In the last stage is called end-stage liver disease, none of the other treatments may work, and liver transplantation is the only option.

Livers can be transplanted from a healthy, living donor or a donor who has died recently (cadaver) from either a heart condition, or a brain-dead person whose heart has stopped working. A part of the liver is taken in case of living donors. This is acceptable as the incomplete liver grows to full size in a couple of months, for both donor and recipient. Living donors can be a family member, friend or an anonymous donor. Both children and adults can receive a donor’s liver and further, the same liver can be used for two people, which is done in the case of cadaver donations. The left part of the liver is used for children and the right part for adults.

Success rates

Liver transplantations are fairly common. In the US alone, there were 7100 transplants done in 2015. The number should be higher for India. They are also fairly successful. Unlike the US where extensive data on liver transplants is maintained and published, such data for India is not easily available. But the American figures can be applied to India or any part of the world for that matter. Across both adult and pediatric transplantation, living and cadaver donations, the success rates are as follows.

Life after transplantation, Dos and Don’ts

Screening of donor and recipient, suitability assessment of the donation, preparing for surgery, what happens during surgery – are all vast topics in themselves. For the purpose of this article, we will focus on life after transplantation.

Hygienic environment

After the surgery, the patient stays in the hospital for 7-10 days where his/her condition is constantly monitored, and then discharged. The patient’s home and immediate surroundings must be as clean as possible, since infection is one of the risks after the surgery. Infection can happen from virus, bacteria and fungi.

The house should be thoroughly cleaned everyday with chemical disinfectants.
The patient must be kept away from toxic chemicals as their fumes can damage the new liver. Pesticides, insecticides, household disinfectants all pose a risk. To reduce the risk, the house should have excellent cross-ventilation. Avoid ACs as these circulate the stale air.
Avoid contact with visitors at home as much as possible.
Avoid contact with pets and animals outside the home.
Avoid people who are ill or have been ill recently due to a viral, bacterial or fungal condition.
The person should avoid visiting dumps and landfills, construction sites, factories where loose material are lying or flying around, slums or places with low hygiene, etc.

Personal hygiene

There are specific dos and don’ts about taking care of the surgery wound, and the doctor will tell the patient at the time of discharge. Other than that …

The person should wear mask while meeting visitors at home and while stepping outside the home.
He/she should wash hands with soap for a full 10 seconds, all over the hand and between fingers, before and after using the washroom, before eating and after touching anything while outside the home.
The person should trim the fingernails regularly and maintain oral hygiene by brushing teeth twice a day and rinsing mouth regularly.

Medication

Since there are many health risks or side-effects after the surgery, various medicines are given to reduce the risk. The new liver can be rejected by the body; so immunosuppressant drugs are given.

The patient must take these medicines religiously, which will gradually reduce over the months.
Follow-up appointments to monitor vitals, change dressings and clean the wound are all very critical and must not be missed for any reason.

Getting back to work

The person can get back to work in 3 months’ times but all the rules about hygienic environment and personal hygiene described above will apply.

Exercise, sports and leisure activities

Mild and moderate exercise can be resumed 3-6 months after the surgery.

Contact sports such as rock climbing, karate, boxing, football, etc. must be avoided.
Avoid team sports and stick to two-player sports like badminton and TT.
Running or jogging for short durations at moderate speed is OK.

Health and Nutrition

Consume clean, healthy and freshly prepared, hot food that is rich in vegetables and whole grains. Check with your doctor before consuming fruits.
Cooking, rinsing the mouth and drinking should always be done with filtered water (RO/UV).
Avoid street-food completely.
Alcohol consumption should be completely avoided.
Avoid deep-fried, oily, stale, left-over, partially cooked and expired packaged food.
Avoid red-meat, eggs or mayonnaise and over-ripe fruits

Outlook

The transplanted liver is supposed to last a lifetime if one takes good care of it. This will reduce the necessity of a re-transplant. If you or any of your dear ones have received a liver transplant recently, stay in touch with a hepatologist or liver specialist at a reputed hospital. There may be many more dos and don’ts than the above, depending on your unique situation, so he/she will advise you on the same. This will go a long way in making your transplant successful and help you live a normal, healthy life.

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Frequently Asked Questions

1. How successful are liver transplants?

Liver transplant success rates are high, with about 86% of patients still alive after one year, and 72% after five years.

2. What precautions should I take after liver transplant surgery?

Maintain a hygienic environment, adhere to personal hygiene practices, take prescribed medications regularly, and attend follow-up appointments.

3. When can I return to work after a liver transplant?

Most patients can resume work within three months after surgery, following proper hygiene and health guidelines.

4. Can I engage in physical activities after a liver transplant?

Mild to moderate exercise can be resumed after 3-6 months, avoiding contact sports and opting for low-impact activities like walking or badminton.

5. What dietary restrictions should I follow post-transplant?

Consume clean, freshly prepared foods rich in vegetables and whole grains, avoiding street food, alcohol, and high-fat or processed foods.

6. How long does a transplanted liver last?

With proper care, a transplanted liver is expected to last a lifetime, reducing the need for re-transplantation. Regular follow-ups with a hepatologist are essential for long-term success.

Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801