Liver Transplant Surgery: Preparation and Procedure

For most people, liver transplant surgery is a life-saving procedure. It involves removing part or all of the diseased liver and replacing it with a healthy one.

We've outlined how a liver transplant procedure works and what to expect so you can prepare for surgery.

When You Get the Call That a Donor Liver Is Available

Your UPMC transplant coordinator will call you when a donor liver becomes available. We will provide you with directions for where you are to report when you arrive at the hospital.

If you're able to find a living donor for liver transplant, you have flexibility in scheduling the surgery.

Before coming to the hospital for your liver transplant:

• Do not eat or drink.
• Bring your driving map and directions to UPMC Presbyterian.
• Bring all of your medications. Make sure your caregiver packs all of his or her medications.
• Pack your cell phone and charger.

If you need to contact someone immediately, call the Abdominal Transplant Coordinator at 412-647-5800.

What to Expect When You Arrive for Liver Transplant Surgery

When you arrive at UPMC, you will be admitted to a patient room where you will:

• Have basic testing.
• Have a history and physical done.
• Sign consent forms for the liver transplant surgery.
• See an anesthesiologist.

Liver Transplant Duration

The duration of liver transplant surgery depends on how complex your case is. On average, the surgery can take between 6-12 hours.

What to Expect During Liver Transplant Surgery

During a liver transplant, your surgeon will:

• Make an incision in your abdomen.
• Cut off the blood vessels to your diseased liver.
• Remove the diseased liver and replace it with the healthy donor liver.
• Reattach the bile ducts and blood vessels.
• Close up the incision.

Your coordinator or surgeon will be able to provide more details about your specific surgery.

Advanced techniques for complex liver transplants

UPMC's team of liver transplant experts performs many complex liver transplant operations. We're equipped to handle the risks of surgery and address any complications.

We also offer “bloodless” surgery for patients who meet strict health requirements. Bloodless medicine means we do not use banked blood products during the operation.

Liver Transplant Surgery Risks

Although many liver transplants occur with little to no problems, there are some risks including:

• Bleeding
• Rejection of the donor liver
• Infection
• Biliary complications
• Primary graft dysfunction (when the liver does not function right away)

These complications can lead to:

• Longer hospital stays
• Increased recovery time
• Even death, in some cases

UPMC uses innovative surgical methods and medications to help prevent or quickly respond to any complications from liver transplant surgery.

What to Expect After Liver Transplant?

Post-op hospital recovery after liver transplant lasts about two weeks. This does vary depending on your health before transplant, so be sure to discuss this with your doctor.

At first, you'll be in the transplant intensive care unit (ICU) as you recover from the operation. Here, the liver transplant team will closely monitor you and your new liver.

You will start taking anti-rejection medications right away to help reduce the chance of liver rejection.

When your body detects something new, your immune system begins working to fight what it views as a threat. Anti-rejection drugs suppress your immune system's natural response to allow your body to accept the new liver.

Once stable, you'll move to a patient room on the transplant floor.

During this time, your liver transplant care team will:

• Help you get up and move around. Being too still right after surgery will increase your risk for blood clots.
• Manage your meals to help you work your way back to eating solid foods.
• Work with you to create a treatment plan for you to follow when you go home.

Before leaving the hospital, your liver transplant care team will review:

• Eating and nutrition guidelines.
• Your medication schedule.
• Tips for becoming more active and things you can and cannot do.
• Follow up visit schedule.

Be sure you fully understand your treatment plan before you leave the hospital.

You will need your caregiver available around the clock to take care of you once you go home.