Recovery & Life After Liver Transplant

It’s common to have questions during your recovery. And sometimes, you might be unsure if the issue is urgent or you should wait until our offices are open again to get an answer. That's why we provide multilingual guidelines to help you decide when to call. 

• Patient Guidelines for Liver Transplant Recipients (English)
• Patient Guidelines for Liver Transplant Recipients (Haitian Creole)
• Patient Guidelines for Liver Transplant Recipients (Portuguese)
• Patient Guidelines for Liver Transplant Recipients (Russian)
• Patient Guidelines for Liver Transplant Recipients (Spanish)
• Patient Guidelines for Liver Transplant Recipients (Traditional Chinese)
• Patient Guidelines for Liver Transplant Recipients (Vietnamese)

Liver Rejection

Your immune system may see the new liver as a threat. Anti-rejection medications help prevent this, but mild rejection episodes can still happen—especially in the first 6 months.

Most rejection episodes are silent and have no symptoms. However, some symptoms, may include fever or tenderness. Liver rejection is often reversible with prompt treatment.

Infection

Immunosuppressants raise your risk for infection. Most common sites: lungs, incision, urinary tract.

The anti-rejection medications you take to prevent and treat rejection allow your immune system to accept your new liver. But they also raise your risk for infection. 

The most common sites of infection are your lungs, your surgical incision, and your urinary tract. Symptoms of infection may include:

You’ll take preventive medications and undergo routine monitoring to catch infections early.

Medication Toxicity

Your liver helps process medications, and dosing must be carefully adjusted post- transplant. We’ll monitor levels closely and provide education so you can stay safe at home.

Never start or stop any medication without your transplant team's approval.  

Bleeding and Blood Clots

Though rare, internal bleeding or blood clots in the liver’s blood vessels may require further treatment or surgery.

Bile Duct Issues

Leaks or blockages may require stents or drainage tubes, often placed without the need for surgery.

You’ll take anti-rejection medications (immunosuppressive) for life, as well as other medicines to:

• Prevent infection
• Manage blood pressure, cholesterol, and fluid retention
• Treat or prevent side effects from immunosuppressants

Anti-rejection medicines include:

• Induction immunosuppressants. These are high-dose medications you receive right after your transplant. 
• Maintenance immunosuppressants. These medications are long-term medication to prevent your body from rejecting your new liver.
• Rescue therapy. This is a medication given if signs of rejection start to develop.

We’ll teach you and your family everything you need to know about managing your medications at home. You're never alone in this process.

Your recovery continues well after you leave the hospital. We schedule your first follow-up before discharge and help coordinate your care.

Typical follow-up schedule:

• Weekly for the first month and eventually every 2 weeks for the next few months Eventually monthly for 6 months
• Then as needed, depending on your health
• You’ll also need bloodwork twice a week during the early months.
• Some patients may need liver biopsies or imaging, especially if bloodwork shows changes.

All follow-up care is coordinated through BIDMC, with seamless support from your transplant team and local specialists

Because of the medication you take, you’re more likely to be affected by germs on or in foods than someone who hasn’t had a transplant. That makes it important to wash all fruits and vegetables thoroughly before eating them. You also should avoid these foods:

Raw shellfish may increase your risk of serious infection from Vibrio vulnificus. (Read more about the dangers of this bacterium at SafeOysters.org, an educational resource from the University of Georgia.) Also, you cannot have grapefruit or any juices or beverages containing grapefruit because they will interfere with your medications.

Because you feel better with your new liver, your diet will be less restricted. Also, some medicines may increase your appetite. To avoid gaining too much weight, it’s important to follow a healthy diet. We can develop an individualized diet plan that considers your needs and any restrictions you might have.

Learn more about nutrition and food safety after transplant.

Caring for yourself after a liver transplant takes effort—but it’s worth it. You’ve overcome so much already, and we’ll be here to guide you toward a brighter, healthier future.

You are not alone. Our team is committed to your recovery and quality of life—every step of the way.

Preventing Long-Term Complications

Immunosuppressive medications can increase your risk for:

• Diabetes
• Kidney disease
• High blood pressure
• Certain cancers (especially skin and lymph node cancers)

With the right follow-up care and lifestyle choices, you can prevent or manage these risks. We’re here to support your long-term health and well-being.