Symptoms and Signs of Liver Transplant

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 8/30/2021

Doctor's Notes on Liver Transplant

Liver transplants are needed when the liver is damaged so severely it impairs a person's health and quality of life. Liver disease severe enough to require a liver transplant can come from many causes. The most common diseases that can lead to a need for a liver transplant in adults include cirrhosis from alcoholism, hepatitis C, and biliary disease. In children and adolescents younger than 18 years, the most common reason for liver transplantation is biliary atresia, which is an incomplete development of the bile ducts.

Symptoms of liver disease include

  • yellowing of the skin or eyes (jaundice),
  • itching,
  • dark tea-colored urine,
  • gray- or clay-colored bowel movements,
  • an abnormal buildup of fluid in the abdomen (ascites),
  • vomiting of blood,
  • blood in the stool,
  • tendency to bleed,
  • mental confusion, and
  • forgetfulness.

What Is the Treatment for a Liver Transplant?

A liver transplant is a complex major surgery. The patient needs intensive monitoring in the time period immediately after surgery. Patients usually go to an intensive care unit (ICU) for a short period after surgery to monitor liver enzyme levels, as well as monitoring for bleeding, infection, or signs of organ failure (primary graft non-function) and rejection.

In patients for whom the post-operative period goes as well as planned, recovery is rapid and patients usually feel much better within 2 to 3 days. The average hospital stay after liver transplantation is 10 to 14 days, with some patients discharged in less than one week. 

After discharge from the hospital, the patient will have close outpatient follow-up with the transplant team. The patient is given very specific instructions to contact the transplant team for any signs of organ rejection. Signs of transplanted organ rejection include:

All patients who receive a liver transplant are placed on immunosuppression medications to prevent organ rejection. These drugs are usually used for the rest of the patient’s life. The dose and type of immunosuppression drugs varies by patient and transplant center protocol. Liver transplantation centers often have their own immunosuppressive therapy regimen protocols. Nearly all transplant center protocols include a calcineurin inhibitor (cyclosporine, tacrolimus), mycophenolate mofetil (MMF), and corticosteroids (prednisone, dexamethasone).

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.