LIVING AFTER LIVER TRANSPLANT

WHAT IS LIVER TRANSPLANT?

A liver transplant is a surgical procedure that removes a liver that no longer functions properly and replaces it with a healthy liver from a living or deceased donor. Recovering from a liver transplant can be a long, slow process, but most people will eventually be able to return to most of their normal activities and have a good quality of life.

It can take up to a year to fully recover, although you'll normally be able to start gradually building up your activities after a few weeks.

WHEN TO VISIT DOCTOR AFTER LIVER TRANSPLANT?

You'll have regular follow-up appointments to monitor your progress after a liver transplant. These will be frequent at first – usually once a week for the first four to six weeks – but eventually only is necessary once every few months, or even once a year.

During these appointments, you will have tests to assess your liver and kidney function, and to check the level of immunosuppressant medication in your blood.

WHAT ARE THE MEDICATIONS REQUIRED AFTER LIVER TRANSPLANT?

The patient needs to take immunosuppressant for the rest of your life after having a Liver Transplant, because there is a risk that the body will recognise the new liver as foreign and the immune system will attack it.

This is known as rejection. Two main types of immunosuppressant are used to treat people after a liver transplant: They are :

• Calcineurin Inhibitors – such as ciclosporin and tacrolimus
• Corticosteroids – such as prednisolone

The risk of rejection is highest in the first three months after a transplant, so it's likely that the patient will be given a relatively high dose at first. The dose will then be reduced to a level thought high enough to prevent rejection, but low enough to minimise unpleasant side effects.

It may take several months before the optimal dose for you is achieved.

WHAT ARE THE POSSIBLE SIDE EFFECTS OF IMMUNOSUPPRESSANT?

Common side effects of calcineurin inhibitors include :

• Headaches
• High Blood Pressure
• Tremor (Uncontrollable Shaking or Trembling)
• Increased Risk of Infections
• Kidney Failure

Common side effects of corticosteroids include :

• Mood Swings
• Muscle Weakness
• Increased Appetite and Weight Gain – care will need to be taken to avoid overeating after the transplant
• Changes to your mental state, such as confusion, hallucinations and suicidal thoughts

Although the side effects may be troublesome, you shouldn't stop taking your medication or reduce your dose without consulting a doctor, because it could lead to your liver being rejected.

CAN YOU EXERCISE AFTER A TRANSPLANT

It's a good idea to get plenty of rest when you first get home from hospital, although you should start moving around as soon as you feel able to.

Start off with gentle activities, such as walking, and gradually increase how much you do over time. You may see a physiotherapist, who can advise you on specific exercises to try.

Contact sports and swimming should be avoided for several months until you have fully recovered, as there is a risk of picking up an injury or infection.

WHEN CAN YOU RESUME NORMAL LIFE?

You should avoid driving for up to two months because the transplant procedure and immunosuppressant medication can affect your vision, reaction times, and ability to perform emergency stops. Speak to your doctor first if you feel ready to drive again.

Some people will be able to return to work after three months, although others may need more time off. Your care team can advise you on this.

Remember that you will need to continue taking your immunosuppressant medications after returning to your normal activities, as there is a risk that your body will reject the new liver if you stop taking them.