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WHAT YOU SHOULD KNOW:
- A liver transplant is surgery to replace your diseased or damaged liver with a donor (another person) liver. Your liver is an organ that lies in the upper right side of your abdomen (stomach). Your liver has many functions including removing waste products from your blood. It breaks down your blood so your body can better use the nutrients. Your liver also helps control your blood clotting. Donor livers may come from someone who has died, or from a living family member. You may receive a whole liver, or just a part of a liver. Partial liver transplants are done because the liver is the only organ that can renew itself, if it is healthy.
- You may need a liver transplant if you have liver failure. Liver failure may be caused by certain diseases that scar your liver and cause it to harden. Viral hepatitis infections may cause your liver to swell and fail. You may need a transplant because of liver cancer. Drinking too much alcohol, too often, also may lead to liver damage and failure. When you need a liver transplant, you will be placed on a transplant list. You may need to wait for a long period of time before a donor liver is found. When a donor liver is found and ready, you will be called to the hospital.
- During surgery, your caregiver will make incisions (cuts) in your abdomen down to your liver. Your failing liver will be removed, and the donor liver will be secured in place. When your new liver is in place and blood is flowing through it, your caregiver will close your abdomen. You may be watched closely in the hospital for a few weeks after your surgery. With a liver transplant, your symptoms such as abdominal pain, swelling, and yellowing skin may resolve. If you have cancer, it may prevent it from spreading. A liver transplant may even cure your cancer.
Take your medicine as directed:
Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
- Antimicrobial medicines: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria. Antifungal medicine may be needed to help kill fungus that can cause infection and illness. Antiviral medicine may help fight an infection caused by a germ called a virus after your transplant.
- Antirejection medicine: Your body tries to attack your new organ like it would attack an infection. These medicines are given to help your body accept your new organ and to keep your body from rejecting it. You may need to take this medicine for the rest of your life.
- Immune globulin: Immune globulin medicine may be given if you have viral hepatitis. The medicine may help decrease your risk for the virus infecting your new liver.
- Steroid medicine: Steroid medicine may be given to stop your body from rejecting your new liver. Steroid medicine also can help decrease inflammation, which is redness, pain, and swelling. This medicine can help a lot but may also have side effects. Be sure you understand why you need steroids. Do not stop taking this medicine without your caregiver's okay. Stopping on your own can cause problems.
- Pain medicine: You may need medicine to take away or decrease pain.
- Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
- Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
- Proton pump inhibitor medicine: This medicine helps decrease the amount of acid that your stomach makes to prevent an ulcer.
- Ask your caregiver when to return for follow-up visits. You may need many follow-up visits with your caregiver after your liver transplant. You may need blood tests often to check the function of your liver. You may need tests to check for any problems with your new liver. These tests include an abdominal ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI). If your surgery was done because of liver cancer, these tests also may show if it has returned. If you are showing signs of liver rejection, you may need a liver biopsy. You also may need an endoscopic retrograde cholangiopancreatography (ERCP) if you have symptoms of a bile duct blockage.
- Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.
You will need to avoid drinks with alcohol after your surgery. Alcohol can damage your brain, heart, and your new liver. Almost every part of your body can be harmed by alcohol. Talk to your caregiver if you start drinking alcohol again, and ask for information about how to stop. You also may want to join an alcohol support group. A support group is a group of people who have, or have had problems with alcohol. A support group may help you stay away from alcohol if it is hard for you to do it on your own.
Blood clot prevention:
Deep vein thrombosis (DVT) is a condition where blood clots form inside your blood vessels. This can easily happen after having surgery. Ask your caregiver for more information about deep vein thrombosis. The following can help prevent clots from forming inside your veins:
- Compression stockings: Your caregiver may have you wear compression stockings. These are tight elastic stockings that put pressure on your legs after your surgery. The pressure is highest in the toe area and decreases as it goes toward your thighs. Wearing pressure stockings helps push blood back up to your heart and keeps clots from forming.
- Walking: Walking may help prevent blood clots and decrease your risk for a lung infection. Walking helps prevent blood from pooling in your legs and causing clots to form inside your veins.
You may have caregivers that visit you in your home to help you with your recovery and medicines.
Keep a healthy weight:
- Keeping a healthy weight can decrease your risk for liver problems. It also can help keep your blood sugar levels normal. Ask your caregiver about what weight is healthy for you, and if you need help losing weight.
- Eat a variety of healthy foods such as fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat, and fish. Eating healthy foods may help you have more energy and heal faster. Ask your caregiver if you need to be on a special diet after your liver transplant.
Your caregiver may want you to go to physical therapy. A physical therapist will help you with special exercises. These exercises can help make you stronger after your surgery.
Pregnancy and birth control:
If you want to become pregnant after your liver transplant, you will need to wait at least two years. Waiting can increase your chances for a safe pregnancy. You will need to use a form of birth control for the two years following your surgery. Talk to your caregiver about what type of birth control is right for you.
After a transplant you are at an increased risk for skin cancer. Your medicines also may increase your risk for sunburn. Always put sun block on when you are outside. It is best to get a sun block with a SPF of 40 or higher. You should also have a yearly skin exam to make sure there are no areas to be concerned about.
If you smoked before your liver transplant, do not start again. Smoking harms the lungs, blood, and your heart. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking.
Your caregiver may help you get vaccinated against hepatitis A and B after your transplant. Vaccinations are shots that help protect you from illness and disease. Your caregiver also may ask you to be vaccinated against the flu each year. The best time to get a flu shot is in October or November.
Follow your caregiver's instructions about how to care for your wounds at home.
CONTACT A CAREGIVER IF:
- You feel very weak or get tired easily.
- You have a fever (high body temperature).
- You have new headaches or shakiness.
- You have pain or tenderness in upper abdomen or wound areas.
- Your legs begin to swell.
- Your skin is itchy or has a rash.
- You have chest pain or trouble breathing that is getting worse over time.
- You have questions or concerns about your liver transplant, medicine, or care.
SEEK CARE IMMEDIATELY IF:
- You are urinating less than normal, or not at all.
- You have a high fever and shaking chills.
- You have a seizure (convulsion).
- You have black, tarry stools, or vomit (throw up) blood.
- You have new yellowing of your skin or the whites of your eyes.
- Your abdomen becomes swollen.
- Your wound areas are swollen, red, or have pus coming from them.
- Your wound is bleeding and will not stop.
- You suddenly feel lightheaded and have trouble breathing.
- You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- You have signs of a stroke: The following signs are an emergency. Call 911 immediately if you have any of the following:
- Weakness or numbness in your arm, leg, or face (may be on only one side of your body)
- Confusion and problems speaking or understanding speech
- A very bad headache that may feel like the worst headache of your life
- Not being able to see out of one or both of your eyes
- Feeling too dizzy to stand
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