Life After Liver Transplant: Recovery and Quality of Living

Before a liver transplant, the patient and the donor are thoroughly evaluated, and all investigations are performed to check whether a surgery can be carried out. Once the transplant expert gives a go-ahead, the patient and the donor are admitted to the hospital for the procedure, which takes about six to eight hours.  After the liver transplant, the patient is taken to the intensive care unit for recovery. Some patients might need a ventilator for assisted breathing.

The patient is given intravenous fluids, antibiotics, and nutritional support. After a few days and depending on the condition of the patient, he or she is shifted to the inpatient room for another two to four weeks before being allowed to go home. Recovery from the liver transplant is a long, difficult, and slow process. It can take from three to six months for the patient to return to normal activities after the transplant procedure.

The Effectiveness of a Liver Transplant

Liver transplants generally have good results. A liver transplant can allow a recipient to live a normal life of more than 30 years after the surgery. Many factors contribute to the success of a liver transplant. The most important factor is the transplant recipients. The recipients are given medications known as immunosuppressants to prevent the rejection of the newly implanted liver by the body (graft rejection).

Failure to comply with the immunosuppressants can lead to damage to the new liver and eventually, may lead to liver failure. It is very important to closely follow-up with your transplant team and the doctor to guarantee good results. The patient must completely follow the medications schedule, lifestyle changes, and infection-avoidance methods recommended by the doctor.

Quality of Life After Transplant

• During the first few months after transplant, the body adjusts to the newly transplanted liver and all the medications are given to maintain its health. Immunosuppressant medications given to prevent graft rejection can have some side effects such as nausea, vomiting, dizziness, headache, increased blood pressure, mood changes, bone and muscle weakness, hair loss or hair growth, increased blood sugar, tremors, and loss of appetite.
• After the patients are discharged from the hospital, they are able to take care of themselves with a few limitations. Most of the patients can return to daily activities and work within three to six months after the liver transplant. Activities such as playing sports, exercising, traveling, and socializing are all possible after a liver transplant.
• Most of the liver transplant recipients can have a normal sex life after liver transplant but it is best to wait for six to eight weeks before resuming sexual activity as it may put stress on the abdominal muscles. Such patients are at a higher risk of getting sexually transmitted diseases due to the use of immunosuppressant medication.
• Use of hormonal pills should be done only after a discussion with the doctor. Female patients are recommended to avoid pregnancy during the first year after transplant. It is important to discuss your family planning with the transplant team and the doctor. Also, such women must undergo laboratory tests. Babies born to immunosuppressed mothers are often underweight but generally healthy.
•  Liver transplant recipients will probably need to avoid driving for up to two months. This is because the immunosuppressant medications can affect their vision, reaction time, and their ability to perform emergency stops.

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Dietary Changes After Liver Transplant

Diet plays a significant role in maintaining the health of our body. Patients are recommended to eat a healthy diet. It is very important to avoid smoking and alcohol after the operation, as they are highly toxic to the liver. Proper nutrition is required for wound healing and rapid recovery. Eating a well-balanced diet is necessary for recovery after a liver transplant.

It is also recommended for liver transplant patients to avoid high cholesterol or sugar levels and avoid weight gain. It is good to consult a dietician for a nutrition plan. Food handling should be very safe for liver transplant patients, as they are at a very high risk of foodborne infections. All food should be thoroughly washed and cooked prior to consumption. It is best to avoid eating raw or uncooked meat, fish, eggs, or poultry. All dairy items and fruit juices to be consumed should be pasteurized.

Role of Exercise

Exercising regularly helps the patient return to normal activities soon after a major surgery like a liver transplant. Exercise should be done under the supervision of a physical therapist to prevent complications of delayed healing or suture breakage. Staying active and controlling weight reduces the risk of a stroke or heart attack.

Reducing the Risk of Infections

After a liver transplant, a patient has to take immunosuppressants to prevent liver rejection by the body. However, these medications weaken the immune system and increase the chances of the patient catching infections easily. To prevent such infections, it is important:

• To practice good hand-washing practices
• Avoid contact with people who have infections or have had recent vaccinations
• Take extra care when handling sharp objects
• Do not share razors, toothbrushes, eating or drinking utensils
• Take medications to prevent infection when prescribed
• Get the flu vaccine early in the flu season

When to Get Medical Help?

It is important for a liver transplant recipient to contact the doctor if he or she has:

• Flu-like symptoms such as high fever, chills
• Vomiting
• Diarrhea
• Yellow skin or eyes (jaundice)
• Dark urine or pale stools
• Itchy skin
• Swollen tummy or ankles
• Redness, swelling, warmth, or pus around the wound
• Trouble passing urine or stool with pain or swelling in the lower belly

These symptoms could be a result of an infection or related to a problem with the liver that needs immediate treatment.

After a liver transplant, a patient can improve recovery by:

• Taking enough rest and sleep
• Trying to walk every day as it helps increase blood flow and prevent constipation and pneumonia
• Avoid lifting heavy things, such as a child, heavy grocery bags, and milk containers, as they can make you strain
• Doing breathing exercises daily will help prevent pneumonia
• Avoiding constipation and straining with bowel movements, and taking a fibre supplement or a laxative on the advice of the doctor
• Keeping the incision area clean and dry
• Changing the bandage every day to prevent infection

Conclusion

Liver transplant recipients must exercise patience, adhere to proper medical care, make healthy choices regarding their diets and lifestyle, take their medications, stay physically active, have regular follow-up appointments with a doctor, and take measures to prevent infections. Adhering to these principles will help the majority of patients return to their normal daily lives gradually. Following medical advice and having a healthy daily routine is very important in achieving long-term success post-transplant and ensuring a high quality of life.