Medications

• Pretransplantation medications
  
  
  • Lactulose: It is important to continue taking this medication because it helps clear the toxins that cannot be cleared when the liver isn't working well. With the doctor's approval, the patient can adjust the lactulose dose to produce 2-3 soft bowel movements per day
    
    
  • Diuretics: These medications promote removal of excess fluid from various parts of the body, such as the abdomen and legs. The excess fluid is lost through urination, and the patient may do this frequently. Daily monitoring of weight is helpful in determining the ideal dose. Routine monitoring of blood test results is an important part of diuretic therapy because important substances are also removed in the urine and may need to be replenished.
    
    
  • Anti-ulcer medications: These medications are routinely given both before and after liver transplantation to prevent ulcers from forming in the stomach or bowels.
    
    
  • Beta-blockers: These medications reduce the chance of bleeding from the gastrointestinal (feeding) tract. They also lower blood pressure and heart rate. They sometimes make the patient feel tired.
    
    
  • Antibiotics: People with liver disease can be more susceptible to infections. The doctor may put the patient on long-term antibiotics if the patient gets repeated infections. The patient should call the doctor if feeling unwell or if he or she has symptoms of infection.

• Posttransplantation medications are discussed in Self-Care at Home. Rejection of the liver is most commonly managed by high-dose steroids, followed by tapering of the medicine over 5-7 days. This treatment is usually effective. Other treatments may be used as alternatives, and these include muromonab-CD3 (Orthoclone OKT3), an immunosuppressive medicine. Rejection therapy also involves treating any infection that may be present with appropriate antibiotic, antiviral, or antifungal medications.