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Liver Transplant Evaluation and Assessment Guide

The recovery period

Immediately post-transplant

After you wake up, you will have a lot of tubes coming out of your body. Most of these will be removed in the first week. The most uncomfortable one may be a nasogastric tube, a NG tube, in your nose. This helps to keep your stomach empty. It will usually come out on the first day.

You will be allowed small amounts of ice chips in order to keep your mouth from feeling too dry and it is likely you will be able to drink on the first day and eat within 2 to 3 days of the transplant.

You will have a Central Venous Line (CVL), which is a large intravenous drip, coming out of your neck. It will be needed to give you fluids and medications until you are able to drink and eat again. This line may be changed for a smaller one on the first day and then it will stay in for about 5 days. If your veins are bad, you may have a drip called a PICC inserted into your arm. This line can stay in for several weeks if you need it.

In order to empty your bladder and monitor your fluids, you will have a catheter in your bladder that will drain urine into a bag. The catheter is usually removed as soon as you are able to get out of bed. Your bowels will not move for 5 or 6 days after the transplant.

2 or 3 drains will come out of your abdomen and will be connected to plastic suction bottles. The drains will drain off any excess blood or fluid from around the wound that is common after a transplant. These drains will gradually be removed between the 2nd and 7th day after your surgery.

Tests

On the first day you will have:

  • a chest X-ray
  • an Ultrasound of the liver to check the blood vessels
  • frequent blood tests

After this, you will have daily blood tests and another ultrasound may be done if your liver tests rise. You may also need a liver biopsy to look for rejection.

The hospital stay

The average length of stay in the ICU is variable and largely dependent on your body’s tolerance of the surgical procedure as well as your pre-operative medical condition. Once you are stable, you will be transferred to 4BT, which is the Kidney and Liver Transplant Unit on the 4th floor Main building. You should expect to spend at least 7 to 14 days in the hospital post transplantation. If you experience complications it can be a lot longer than this.

After your transfer to the transplant ward, you will be seen by a physiotherapist who will instruct you on getting in and out of bed and work with you in rebuilding your strength.

You will also be encouraged to do coughing and deep breathing exercises in order to keep your lungs clear and expanded. This will help prevent chest infections. Remember that the location of your liver is in the right upper portion of your abdomen and is therefore directly below your right lung. This part of the lung can collapse during the surgery and fluid may collect in the chest cavity, called a pleural effusion. Frequent coughing and deep breathing will help this fluid get better and expand your lungs.

You will begin to eat shortly after transplant. You will begin with liquids and progress to solid food. Well-balanced, high protein meals are necessary because your body will need adequate calories and protein in order to heal and rebuild itself. Few dietary restrictions are necessary. To help with your individual needs, the transplant dietician will discuss and instruct you on foods that will be beneficial in this rebuilding process. Before discharge, the transplant dietician will counsel you individually on the long-term nutritional guidelines that you will need to follow.

Throughout your stay in the hospital, the transplant team will record your daily lab and test results on a computer. This will provide an overall picture of how you are doing. We feel that discussing your results and the intended plan of care while in your room provides an additional learning opportunity for you. Please do not hesitate to ask questions during this time.

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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