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How To Enjoy Good Health After A Liver Transplant

For those with chronic liver failure, a liver transplant is the best option to enjoy a long, healthy life. After the procedure, it is important to know how to adjust to life after the transplant. A liver transplant surgery is undertaken to remove an organ that doesn’t function normally, replacing it with a healthy one from a deceased donor or part of a healthy liver received from a living donor.

An Overview

As the largest internal organ, the liver performs various critical functions. These include the production of bile to help the body absorb cholesterol, fats and fat-soluble vitamins; process nutrients, hormones and medications; remove toxins and bacteria from the blood; make proteins that assist the blood to clot; prevent infection and regulate the immune response.[1]

Typically, liver transplants are only for those with major complications arising from end-stage chronic liver disease. It may also be a treatment choice in case of sudden liver failure, which is rare. However, the waitlist of patients requiring a liver transplant exceeds the deceased donor liver numbers.

Therefore, it may be advisable to find a living donor instead of waiting for a deceased donor liver. A liver transplant from a living donor is feasible since the liver regenerates quickly, regaining its normal size soon after part of the organ is removed surgically.

Recovery Period and the Possibility of Rejection

Generally, it could take around six to twelve months after a liver transplant to restart one’s normal/near-normal routine. Nonetheless, there is no standard timeframe and healthy individuals could recover faster after the transplant. Considering the operation’s complexity, patients could be hospitalised for several weeks. Depending on the patient, the hospitalisation stay may be shorter.

During the recovery period and thereafter, the patient will need to have regular blood work – a set of blood tests to detect if he/she has any medical condition. These tests are crucial to know if the body is accepting the new liver. While these tests will always be required, their frequency reduces with time.

Every liver recipient runs the risk of their body rejecting the new organ. When the immune system detects the transplanted liver, it considers it an invader, just like any infection. The body’s immune system will then reject the new organ and attack it.  Such a situation could trigger an organ failure, even endangering the patient’s life.

The Key Role of Anti-rejection Medications

However, the threat can be managed with anti-rejection medications, which suppress the immune system, preventing i from attacking and damaging the new liver. To ensure the complete efficacy of anti-rejection drugs, they must be taken daily, precisely as prescribed and throughout a patient’s life.

Other steps will also need to be taken so that the anti-rejection drugs work effectively, such as:

  • Adhering to all the scheduled blood test appointments. Often, these tests discover signs of organ rejection much before the recipient notices symptoms. Anti-rejection medications are then revised as required.
  • Inform the doctor about other medicines, vitamins or supplements being consumed as some may lower the effectiveness of anti-rejection drugs.
  • Avoid the consumption or drinking of grapefruit juice since it can interact negatively with anti-rejection medications.
  • Inform the doctor right away if anti-rejection drugs are causing unpleasant side effects like headaches or diarrhoea, but never change the medicine routine except on the doctor’s advice.

Some Signs of Organ Rejection

Organ rejection risk remains high for three to six months after the liver transplant. If a new liver is being rejected, the likely symptoms could include tiredness, fever, abdominal pain or tenderness, yellowing of the skin or the eye whites, dark urine and light-coloured stools.

Note that rejection may not always manifest via perceptible symptoms. Yet, blood tests could detect such symptoms. That is the primary reason for liver transplant recipients to strictly follow the blood test appointments.

At any time, if the patient feels he/she is experiencing some likely symptoms of rejection – like a sore throat, cough, chills, a stuffy nose, diarrhoea and vomiting – it’s best to call the doctor immediately. Based on the reported symptoms, the doctor will decide if a biopsy is required to check if the patient’s body is rejecting the donor liver.

A Healthy Post-operation Routine

Additionally, recipients must adhere to a healthy lifestyle regimen to facilitate healthy liver function. The priority is to consume a nutritious diet low in salt, sugar, fat and cholesterol. High-fibre items such as fruits and vegetables, fish and lean meat (e.g., skinless chicken) are preferable. Drink plenty of water and avoid alcohol completely since it can damage the liver.

Embrace an active lifestyle since exercise keeps a person physically and mentally sound. One can begin taking walks once the doctor grants permission after the surgery. Exposure to germs must always be curbed as anti-rejection drugs put patients at higher risk of contracting infections by suppressing the immune system. Therefore, avoid people with cold, flu or other contagious infections. 

Always take vaccines as scheduled since they will reduce the possibility of serious ailments. However, ‘live’ vaccinations like the chickenpox vaccine must be avoided as they may end up triggering the disease meant to be prevented. The treating physician will clarify which vaccines are safe.

Long-term Prognosis, Side Effects and Outcomes

Long-term immunosuppressant drug use can inflate the risk of developing skin and other cancers. Again, the liver transplant surgeon will help in determining the screenings that are appropriate for these patients.

Most liver transplant recipients enjoy excellent outcomes. Some have been known to lead normal lives for more than three decades after the operation. Nevertheless, patients are primarily responsible for successful outcomes of their liver transplant surgery as non-adherence to the immunosuppression compliance guidelines is the chief cause of organ failure. Adhering scrupulously to medication timings, infection-avoidance techniques and lifestyle changes are crucial to prolong life after transplantation.

Many medications may have side effects. The side effects of some post-transplant drugs include high blood pressure, elevated blood sugar, nausea, diarrhoea, vomiting, headache, mood swings, hair loss or even hair growth, bone and muscle weakness and kidney dysfunction. Initially, while most patients may have side effects, these will diminish with time as the dosage of medications is reduced.

Even if some side effects seem troublesome, recipients should never discontinue medications without the express advice and consent of the transplant team. When the side effects seem severe, the drugs can be adjusted to enhance the tolerance levels of patients.

After the transplant, it could generally take about three months before a patient returns to work. Some patients may temporarily need light assignments while they can gradually reacclimatise to the workplace. If patients follow the recommended post-transplant lifestyle changes and habits, their chances of leading a healthy life will be high.