Whether you're giving away part of your liver or getting a new one, life often goes back to normal a few months after surgery. By the time you hit the 3-month mark, your liver will probably reach its normal size and you'll be back to your regular routine.
During Your Hospital Stay
If you're a donor, you'll stay in the hospital about a week. You may feel weak and tired after your surgery. Expect to feel some pain. It's perfectly normal, and you can get relief easily with pain medication, says Yuri Genyk, MD, director of the University of Southern California's liver transplant program.
Within the first day or two, your doctor will ask you to get up, move around, and do breathing exercises. This speeds your recovery and keeps blood clots, pneumonia, and muscle loss from setting in.
If you're getting a new liver, you'll be in the hospital about 6-8 days. How long you stay may depend on your health before the transplant, says John C. LaMattina, MD, assistant professor of surgery at the University of Maryland School of Medicine.
"You may be on IV pain medications for 2 or 3 days, then oral medications that you'll go home with," LaMattina says.
You'll also take drugs to keep your immune system -- your body's defense against germs -- from rejecting your new liver. You may hear your doctor call these medicines immunosuppressants. You'll take high doses right after your operation and will start tapering the amount when you leave the hospital.
Expect to take these medications for the rest of your life, says Jennifer Lai, MD, a transplant hepatologist at the University of California, San Francisco. You may eventually take fewer pills or lower doses, but you'll always need some form of them.
The First Month
If you're a donor, you'll go home when you're comfortable and are ready to do things by yourself, LaMattina says. Plan on getting a checkup about 2 weeks after surgery, then again at regular intervals.
Your liver will grow back quickly. A lot of the growth happens in the first 2 weeks. It's working hard, so you may feel very tired, especially in the first month, Genyk says.
You may still need pain medication. Most people taper off in 2-4 weeks. If you have an infection from the operation, you may also need antibiotics.
Your doctor may recommend deep breathing and light exercise. Daily walks help you recover. You'll have some limitations, though. Until your belly heals, you shouldn't lift anything heavier than 15-20 pounds.
You may need help with daily tasks like shopping or cooking. Ask a friend or family member to lend a hand. You won't be able to drive right away, especially if you still take pain medication.
If you're getting a new liver, you'll get a checkup within a week of leaving the hospital. "We have to monitor drug levels and make sure everything is doing well," LaMattina says. You may have weekly checkups for the first month and a half, then less often.
Depending on how you feel, you may still use pain medication. "Some people are off in 2-3 weeks, while some people take it longer," LaMattina says.
You may go to physical rehab for a week or two, or you may not go at all. Everyone's different, LaMattina says.
At first, you won't drive. When you're off pain medication and can go up and down stairs comfortably, your doctor will give you the OK to get behind the wheel again.
Watch Out for Complications
Most people do well after surgery, but sometimes there are complications. Here's what to look out for:
If you're a donor, most complications -- like nausea, fever, or mild infection -- happen during the hospital stay. After that, it's possible to have a hernia, bowel problems, or emotional issues.
See your doctor if you have pain or a fever. "If anything just doesn't feel right, call us," LaMattina says.
If you're getting a new liver, call your doctor if you have a fever higher than 100.4, your skin looks jaundiced (yellowish), you feel itchy, or you have headaches, tremors, or diarrhea, Lai says.
They may be signs of infection or other problems, like bile duct leaks, bleeding, hepatic artery thrombosis, hepatitis, or liver rejection.
The Next Few Months
At this point, you can look forward to getting back to your normal life. The goal is 2-3 months.
Most donors and recipients go back to work 6-8 weeks after surgery. It varies based on how you felt before and what type of work you do. "A desk job is easier to get back to than physical labor," LaMattina says.
Around the same time, you can also get back to more rigorous exercise, like swimming, running, and cardio work. Be sure to start slowly, and be careful with abdominal exercises. Just a few reps at a time will help you work up your strength.
Things will probably improve from there. If you received a new liver, you'll have better health, more energy, and even an improved memory, Genyk says. If you're a donor, your liver will probably have grown back to a normal size now, and you'll be back in full swing.
"This is a lifesaving operation, not just life-changing. When it ends well, we see both joy and gratitude," Genyk says.