After transplant

Living with a transplanted organ is a gift but also a major responsibility. The transplant team works with patients and their families before the transplant to help prepare them for what's to come. Once the transplant has occurred, transplant recipients and caregivers need to learn about how to protect their new liver, recognize signs of rejection, and sustain a healthy lifestyle to support their new organ.

Post-transplant patients are educated about and provided with information regarding:

  • Infection and rejection
  • Dietary issues
  • Vital sign monitoring
  • Medications and side effects
  • Care of the T-tube and wound
  • Liver biopsy indications and protocols
  • Hygiene and dental care
  • Activity and exercise
  • Discharge plan and long-term follow-up

Outpatient Management After Transplant

Patients are discharged from the hospital eight to fourteen days following liver transplantation. After initial discharge, until three months post-transplant, patients are seen in the transplant surgery clinic. After three months post-transplant, patients transition to the transplant hepatology clinic for continued management. 

The frequency of clinic visits are as follows:

  • Weekly and bi-weekly (months 0-3): Transplant surgery clinic
  • Once a month (months 3-6): Transplant hepatology clinic
  • Once every three months (months 6-12): Transplant hepatology clinic
  • Once every six months (months 12-24): Transplant hepatology clinic
  • Once a year after 24 months: Transplant hepatology clinic

The transplant hepatology clinic is designed to do a comprehensive review of laboratory data and diagnostic studies reflective of liver function, manage the immunosuppressive regimen that each patient is following, and monitor for recurrence of viral hepatitis. Each patient will be referred back to the primary care physician or gastroenterologist for routine health maintenance. The University of Maryland transplant team will continue to collaborate with the referring physician to ensure a cohesive patient management plan. 

Routine Outpatient Laboratory Testing
Routine laboratory tests are necessary to monitor for the following: drug toxicity, graft rejection, infection secondary to immunosuppression, and the response of liver enzymes after treatment for graft rejection or after a change in the immunosuppressive regimen. Infection and graft rejection most often occur within six months following transplantation. In the event that one or both of these situations occurs, the frequency for laboratory testing will increase in order to closely monitor the patient's overall response. Our current protocol for laboratory testing is:

  • 3-6 months post-transplant - labs every two weeks
  • After 6 months - labs every month

Routine laboratory tests include: CBC with differential, standard chemistries with a liver profile (ALT, AST, Alkaline Phosphatase, and bilirubin) and a Cyclosporin (Neoral) or FK506/Tacrolimus (Prograf) level. Patients can have laboratory testing done at Associates in Pathology Laboratory located at University of Maryland Medical Center, at a preferred diagnostic center that is designated by a HMO, or at the referring physician's office.


This page was last updated: December 4, 2013

         
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