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Liver Transplant Evaluation and Assessment Guide

Intensive Care Unit (ICU) patient information

You will be transferred to the Intensive Care Unit (ICU) immediately after your operation and probably before you wake up from the anaesthetic. You will have a registered nurse with you at all times.

This information is intended to help you and your family to become familiar with the machines and surroundings of the ICU. We hope this will help to address some of the concerns you may have regarding your time in Intensive Care. If you or your family have any questions do not hesitate to ask any of the staff.

Breathing

You will have a breathing tube, an E.T. tube, in your mouth and this is attached to a ventilator to help with your breathing until you are more awake. The tube lies between your vocal cords so you will be unable to talk when it is there. You will be well sedated while this tube is in, but it may be a little uncomfortable as you are waking up. When you are fully awake and breathing for yourself the tube will be removed. You may have a sore throat and your voice may be husky.

A physiotherapist will visit you several times during your stay. They will help you to take deep breaths and cough up any secretions from your lungs. You will feel some shaking and vibrations on your chest to loosen the secretions. While the breathing tube is in place we will remove secretions by passing a smaller tube down it and applying suction. This will cause you to cough and take your breath away for a few seconds

Tests

When you get to ICU you will have a chest x-ray, blood tests and an ECG, a heart tracing. These tests will be repeated daily while you are in ICU.

Pain relief

The nursing and medical staff will frequently check to see if you have any pain. Please tell us if you are sore or have any pain so we can attempt to relieve it. A pain score of 0 to 10 is used, with 0 being no pain and 10 being severe pain. It is important that you are relatively pain free and can cough and take deep breaths as this helps to avoid post-operative complications such as pneumonia. Pain relief is normally given through a Patient Controlled Analgesic machine with a push button that you will operate yourself. You will then be transitioned to pain relieving tablets. Overall, those who have undergone liver transplantation say that there was not as much pain involved as they anticipated. We believe this is due, in part, to the type of incision that is made, plus the use of steroid medications.

Noise

Intensive Care is a busy ward and can get quite noisy. While you are lying in the ICU bed without anything to do, noises will seem to be much louder than they actually are. Most of the noise is from monitor and ventilator alarms. Don’t be concerned if your monitor alarm sounds. Staff will explain what the alarms mean. We aim to have a quiet time from 10.30pm to 6am to let patients sleep, however, due to the needs of our sicker patients this cannot always be achieved.

In this guide:

  1. Information and contact details for the liver transplant hepatology team
  2. The liver - its function and anatomy
  3. Signs of liver disease
  4. Pre-transplant assessment and evaluation
  5. The assessment team
  6. Allied Health Services
  7. Palliative care
  8. Pharmacy—medications before your transplant
  9. Case discussion and assessment presentation
  10. Will I make the list?
  11. The liver transplant waiting list
  12. Model for End stage Liver Disease (MELD)
  13. Support Through Education Program (STEP)
  14. The Donor
  15. What happens when you are notified that a donor liver is available?
  16. The liver transplant operation
  17. Intensive Care Unit (ICU) patient information
  18. The recovery period
  19. Pharmacy—medications after your transplant
  20. Rejection
  21. Donor family correspondence and information
  22. Glossary

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Last updated:
25 November 2022
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