After The Transplant And Leaving Hospital
Once the operation is complete, you will be taken to intensive care. When you wake up you will:
- have a tube in your throat and are attached to a ventilator to help you breathe
- are attached to machines which help your doctors monitor your condition
- have a tube in your nose.
When you start breathing normally the tube in your windpipe will be removed and you will be given oxygen through a face mask. You might have a bit of a sore throat at this point and the nurses will then take you through a few breathing exercises. You will also be given several pain relief injections.
Over the next few days you will continue to be given pain relief. You may be able to control this yourself via a PCA (pain-controlled analgesia or 'Pica') device. You will have routine blood tests and chest X-rays and you will also be given antibiotics.
Leaving the hospital
Your transplant team will take you through what you can expect when you get home. Once you are at home you should be contacted by your transplant coordinator who will see how you are getting on.
To prevent your body rejecting a new healthy liver you will need to take a number of medicines, including strong drugs known as immunosuppressants.
Go through each medicine carefully with your healthcare team as some medications react badly with others, as well as certain foods. If you have any questions talk with your doctor or pharmacist.
Some of the drugs that you will be given can have side effects, including:
- kidney damage
- high blood pressure
- high cholesterol
After about two days you will be moved onto a ward. Over the next few days you will find that you can move about more and will be encouraged to do so.
You can begin to eat between one and five days after the operation, with advice from a dietician.
It is quite common to feel a bit low after the operation. This is normal and is caused by the stress of having a major operation and the drugs you are taking. Other side effects of the drugs include vivid dreams and nightmares, with some people experiencing waking hallucinations.
If you are worried about the side effects of the medicine talk to your GP, the hospital pharmacist or your liver team.
You may be given regular booster vaccinations against disease. If so, these will never be in the form of a live vaccine and will not be started for at least six months after your transplant.
If you are planning to travel to another country talk to your doctor. There are two things you must think about:
- It is vital that you do not have a live vaccination as this will react very badly with the drugs (immunosuppressants) you are taking to stop your new liver being rejected.
- Always make sure that you have enough medicines to last you for the entire trip, with a few extra to cover any delays or emergencies.
When you get home it is normal to feel anxious and disorientated. You may also feel very tired. This is normal. If you have any worries contact the transplant team. In emergencies contact the transplant coordinator. Bear in mind the following points.
- Exercise – the hospital physiotherapist will give you a gentle exercise plan. This will help your recovery and should be built up slowly. Avoid any contact sports or swimming for six months.
- Driving – because you have had an operation in the abdominal area you should avoid driving for two months after the operation.
- Blurred vision – this is quite normal for the first few months after the transplant and should get better after a time.
- Telling people about your transplant – you must make sure that other medical professionals, such as a doctor, dentist or optician, know about your transplant before they give any treatment.
- Work and money – getting back to work will depend on whether you have any complications and your general rate of recovery. Some people, although not the majority, can return to work around three months after the transplant. The hospital can arrange for you to see a social worker to help you if you face financial hardship because of time spent off work.
Infections – because of the strong drugs (immunosuppressants) you have to take after
the operation you will be far more at risk of infections. It is important that you do not smoke afterwards and that you maintain good personal and domestic hygiene. People who have infections should not visit you and you should stay away from large crowds or gatherings.
Skin cancer – after the transplant you will be at far higher risk of skin cancer. If you go on holiday to sunny spots abroad or are just spending more time outdoors you should always protect yourself from the sun. Keep an eye out for any changes in your skin and in any moles or spots.
Sex – you can resume sex as soon as you feel ready. Men can find that it can take a couple of months for everything to work normally again. If you have any concerns you should discuss them with your doctor. Both women and men have a higher risk of contracting sexually transmitted diseases (STDs) so take extra care and practice safe sex.
Menstruation – after the transplant women will find that their menstrual cycle is disrupted, returning to normal in two to eight months. Some medications stop periods happening but care should be taken as this does not mean you cannot get pregnant.
Pregnancy – women hoping to get pregnant should get advice from their doctor. In general you should wait for 12 months after the operation before trying to get pregnant.
Pets – it is not a good idea to keep exotic pets or birds after a transplant as the risk of picking up disease is higher. Always wear gloves if you have to come into contact with any of your pet's body fluids, such as saliva and faeces, and wash your hands afterwards.