Everyone recovers from liver transplantation differently. Depending on your child's condition, he or she will be hospitalized for two to three weeks following the transplant. We encourage you to stay within the Salt Lake City area for two to three months after the transplant. Our social workers will assist you with temporary housing.
Your child will have blood drawn often for the first 2-3 months and will be seen in the Transplant Clinic one to two times per week. The number of blood tests and clinic visits will decrease as your child’s condition becomes stable. You will be notified about any adjustments in your child's medications.
Even years after transplant, your child will have lab tests at least once every 3 months and visit the transplant clinic every 6 months. Transplant-related issues become less likely as time passes, but may occur for the rest of your child’s life. Regular follow-up lab work and clinic visits are the best way to find any problems as early as possible.
A liver transplant gives children a second chance at life. The care they need after transplantation will seem overwhelming at first, but families soon fall into a routine. The liver transplant doctor will tell you when your child is safe to return to school (usually within 6 weeks after leaving the hospital). Learning about transplantation will be a continual process throughout your child’s life. Joining support groups and talking with social work professionals can help you and your family through this difficult but rewarding process.
Complications can occur with any kind of surgery, and patients undergoing organ transplants may face additional complications. The life-threatening disease that created the need for your child's transplant may affect the functioning of other body systems. Other problems, such as rejection of the new liver, may also happen.
Some possible transplant complications and medication side effects include:
- Hemorrhage — One function of the liver is to make chemical components used to help blood clot, called clotting factors. When a liver fails, the ability to make clotting factors is weakened. To correct this problem, your child will receive blood products before, during, and after surgery. We expect the new liver will start working very quickly to help prevent any excessive bleeding, but your child may need to return to surgery to control the bleeding, particularly if it occurs within the first 48 hours after transplant.
- Thrombosis — If a blood clot forms in a vessel leading to or from your child's liver, this may injure the new liver. This is considered a serious complication that may require a second transplant. Your child will receive special anticoagulation medication to prevent this from happening.
- Rejection — Your child's immune system protects him or her from invading organisms. Unfortunately, it also views the new liver as foreign and will try to destroy it in an attempt to protect your child. This is known as rejection. To prevent this from occurring, your child must take special immunosuppressive medication for the rest of his or her life.
Liver rejection often happens with no outward symptoms. Therefore, it’s important to have lab tests regularly. Prevent rejection by:
- Giving your child all medicines as the doctor prescribed
- Keeping follow-up appointments
- Calling the transplant office immediately if you notice any signs of rejection
Your child may need a liver biopsy to diagnose rejection. The liver transplant team can treat rejection with medication adjustments. Your child may also need to be hospitalized to prevent continued development of rejection, if possible.
Immunosuppression drugs decrease your child's resistance to foreign bodies, such as the new liver. Your child will need to take these medications for the rest of his or her life or the liver will be rejected. Immediately after surgery, the doses will be high since the chance of rejection is greatest at this time. Dosages will be lowered quickly once clinicians determine a low risk of rejection.
The medications have side effects, which are usually dose-related. Most people experience the most side effects in the beginning when medication dosages are high. As the dosage is lowered, the effects will lessen. Side effects may occur in some patients and not in others.
Immunosuppressive medications also weaken the child's ability to fight off infections. Your child will be given medication to help prevent infections, but also use caution and avoid contact with people with infections, especially during the first three to six months after transplant.