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.
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 4 to 6 weeks – but may eventually only be 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 (see below) in your blood.
You'll need to take immunosuppressants for the rest of your life after having a liver transplant, because there is a risk that your body will recognise the new liver as foreign and the immune system will attack it.
This is known as rejection. See our page on liver transplant complications for more information on rejection.
2 main types of immunosuppressants 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 3 months after a transplant, so it's likely that you will be given a relatively high dose at first. Your 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.
Common side effects of calcineurin inhibitors include:
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 – contact your GP or a member of your care team as soon as possible if you experience these
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.
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.
Most people will need to have a normal, healthy diet after a liver transplant.
Try to maintain a healthy weight as much as possible, although this can be difficult if you are taking steroid medication. Ask to see a dietitian if you think you may need advice on your diet.
If the previous problem with your liver was caused by alcohol misuse, you will normally be advised to abstain from alcohol for life after a liver transplant.
It may also be a good idea not to drink alcohol even if you're liver problem wasn't alcohol-related, although in some cases it may be fine to do so in moderation.
Speak to your care team for advice.
Sex and pregnancy
You can start having sex again as soon as you feel physically and emotionally ready.
Make sure you use appropriate contraception, however, as women who have had a liver transplant are usually advised to avoid becoming pregnant for at least a year.
If you do become pregnant, inform your care team, as immunosuppressant medication could potentially affect your baby and you may need extra monitoring.
If you're thinking about planning a pregnancy, you should discuss this with your care team first because your immunosuppressant medication may need to be changed to reduce the risk to your baby.
Driving and returning to work
You should avoid driving for up to 2 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. It's also often a good idea to inform your insurance company of your situation.
How long you need to be off work will depend on your job and how quickly you recover. Some people will be able to return to work after 3 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.