Having a liver transplant

This page tells you about transplant surgery for primary liver cancer. There is information about

A quick guide to what's on this page
What the operation involves
Preparation for your operation
When you wake up
Starting to get better

What does the operation involve?

A liver transplant is a very big operation and usually takes between 6 and 10 hours. All surgery is done under general anaesthetic. A transplant actually involves 3 operations. These include removing the donor liver, removing your liver and implanting the donor liver into you.

When you wake up

When you come round, you will be in the intensive care unit. You will be on a ventilator at first. This is a machine that helps you to breathe. As soon as your doctors are happy that you can breathe comfortably alone, they will take out the breathing tube. You may also have

Tubes into your neck to measure your blood pressure and give you medicines and fluids
A drain from your wound site to drain away blood and tissue fluid
A tube down your nose and into your stomach (nasogastric tube) to drain it and stop you feeling sick
A tube into your bladder to drain away your urine

These will all be removed quite quickly as you get better. Once you are making a bit of progress, your specialist will move you into the high dependency unit. This is an area where you still have more close care than in a regular ward. You will stay in hospital for about 3 weeks.

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A liver transplant is a very big operation and usually takes between 6 and10 hours. All surgery carried out on the liver is done under general anaesthetic.

There are really 3 operations

Removing the donor liver
Removing your liver
Implanting the donor liver into you

The medical staff will explain in detail what each of these operations involves. The whole thing takes a few hours and this can put a strain on your heart and lungs. So you will be in intensive care after your operation.

Your doctors and nurses will talk to you about how you will feel after your surgery. They will tell you about the tubes you’ll have and the painkilling drugs you may need when you wake up. One of the most important things to talk about is the medication you will need to stop rejection of your new liver after your operation.

Before your operation, you will need

A chest X-ray
A heart trace (ECG)
Blood tests
Your temperature checked

The X-ray and temperature and some of the blood tests are to check for infection. The ECG checks the health of your heart. The rest of the blood tests check the health of your kidneys. You will have all this done when you arrive at the hospital. Overnight, you may have medicines, fluids, or blood products through a drip to make sure everything is as good as it can be.

Your nurse or physiotherapist will teach you breathing and leg exercises. You can help yourself recover by doing these when you are told you need to after your surgery. These exercises will help to stop chest infections and blood clots. Both of these complications can happen because you are not moving around as much as you normally would be. You will also have elastic stockings to put on before you go down to theatre. These also help to prevent blood clots.

When you come round, you will be in the intensive care unit. This is normal for this type of surgery and helps to make sure you get all the attention you need from the nurses and doctors. You may be kept asleep for a few days after the operation so you can rest and your body can start to recover. You will be on a ventilator at first. This and the other tubes can be quite frightening if you aren’t expecting it, but it helps to know what they are all for.

The ventilator is a machine that helps you to breathe. As soon as your doctors are happy that you can breathe comfortably alone, they will take out the breathing tube. You may then have extra oxygen through a mask over your face for a while. Other tubes you may have include

Tubes into your neck to measure your blood pressure and give you medicines and fluids
A drain from your wound site to drain away blood and tissue fluid
A tube down your nose and into your stomach (nasogastric tube) to drain it and stop you feeling sick
A tube into your bladder to drain away your urine

These will all be removed quite quickly as you get better. You will also have wires taped to your chest and a clip on your finger. These monitor your heart, pulse, and the level of oxygen in your blood.

You may have a very fine tube into your back. This is an epidural. Your anaesthetist will use it to give you painkillers into your spinal fluid for a few days after your surgery. This is a very effective way of controlling pain.

Your nurses and physiotherapists will keep encouraging you to do your breathing exercises and to cough. This is very important in preventing chest infections. It is very important to tell them if you are in pain. You should have enough painkillers to enable you to breathe and cough.

Once you are making a bit of progress, your specialist will move you into the high dependency unit. This is an area where you still have closer care than in a regular ward. The day after you arrive, your nurses will help you out of bed and up into a chair. This is bound to be a bit daunting. But most people feel that they are really making progress once they’ve managed this.

There are a number of possible complications from this surgery that may happen in the first few weeks after your operation. It is important that you are close to medical help during this time. For this reason you will need to stay in hospital for about 3 weeks. There is more information about possible complications of having a liver transplant including rejection of your new liver in CancerHelp UK.