Liver transplant living
Informed by recognized medical guidance
Overview
A liver transplant is a surgery where a diseased liver is replaced with a healthy one from a donor. This article is about living well after that surgery, including how to stay healthy, what to watch for, and how to get support.
Key facts
- A liver transplant can be a life-saving operation for people whose liver has stopped working.
- After a transplant, you will need to take medicines every day to stop your body from rejecting the new liver.
- Most people who have a liver transplant go on to live active, fulfilling lives.
Liver transplant is a well-established treatment, but it is not common. Every year, thousands of people around the world receive a liver transplant, and the number is increasing.
Liver transplants are done for people of all ages, from babies to older adults. It is used when the liver fails and no other treatment can keep the person alive.
Symptoms
- Difficulty breathing
- Pain or pressure in the chest
- Sudden confusion or loss of consciousness
- Signs of stroke (one-sided weakness, drooping face, trouble speaking)
- ⚠Fever over 100.4°F (38°C) or any fever after transplant
- ⚠Yellowing of the skin or eyes
- ⚠Dark urine or very pale stools
- ⚠Severe abdominal pain
- ⚠Vomiting that will not stop
- ⚠Feeling extremely unwell or weak
Common symptoms
- Feeling very tired
- Mild pain or discomfort in the belly
- Low appetite
- Swelling in the legs or ankles
- Fever or chills
- Jaundice (yellowing of the skin or eyes)
Symptoms in children
- Being unusually fussy or irritable
- Poor feeding or poor weight gain
- Sleeping more than usual
- Swollen belly
- Changes in skin color
Symptoms in older adults
- New or increased confusion
- Feeling faint or dizzy
- Less urine than usual
- Severe weakness or being hard to wake up
Causes
Main causes
- End-stage liver failure from cirrhosis (severe scarring of the liver)
- Acute liver failure that happens suddenly
- Liver cancer that has not spread beyond the liver
- Bile duct diseases
- Genetic or inherited liver conditions
Risk factors
- Long-term hepatitis B or C infection
- Long-term heavy alcohol use
- Non-alcoholic fatty liver disease
- Autoimmune liver diseases
- Conditions present from birth (like biliary atresia)
When to see a doctor
See a doctor urgently if:
- Any sign of infection, such as fever or chills
- Signs of rejection, like jaundice or new belly pain
- Suddenly feeling short of breath or very weak
- Any new or unusual symptom after surgery
Book a routine appointment if:
- Keep all scheduled follow-up visits with your transplant team
- Get regular blood tests as they recommend
- Report any gradual changes in how you feel
Diagnosis
After a liver transplant, you will be monitored closely. The doctor checks for signs of rejection, infection, and how well the new liver is working.
Tests that may be done
- Blood tests to check liver function and levels of transplant medicines
- Liver ultrasound or other imaging scans
- Liver biopsy (a small sample of liver tissue is taken to check for rejection)
- Regular checks for infections like cytomegalovirus (CMV) or hepatitis
What to expect at your appointment
You will have frequent checkups at first, then less often over time. These visits are to keep your new liver healthy and adjust your medicines if needed. Your transplant team will guide you step by step.
Treatment
Life after a liver transplant is a long-term treatment journey. The main treatment is taking medicines that stop your immune system from attacking the new liver. You will also need to manage other health conditions and prevent infections.
Self-care at home
- Take your medicines exactly as prescribed, at the same time every day
- Never stop or change your medicines without talking to your transplant team
- Wash your hands often and avoid people who are sick
- Wear sunscreen and protect your skin, because transplant medicines increase skin cancer risk
- Keep a list of all your medicines and show it to any doctor you visit
Medical treatments
Your transplant team will prescribe one or more immunosuppressant medicines to stop rejection. These medicines need to be balanced carefully to avoid increasing your risk of infection. You may also take medicines to lower blood pressure, control blood sugar, or protect your bones. Your team will tailor your treatment to your specific needs and monitor you closely.
When is surgery considered?
You have already had the transplant surgery. In rare cases, further surgery may be needed if there are complications like bile duct problems or a blocked blood vessel. Your team will explain if this is ever considered.
Living with this condition
Your daily life will slowly return to a new normal. You can often return to work, school, hobbies, and travel after recovery, but you need to plan ahead. Keep a routine for medicines, stay hydrated, and get plenty of rest. Avoid large crowds during cold and flu season, and wear a medical alert bracelet that says you have a transplant.
Lifestyle tips
- Avoid alcohol completely, as it can harm your new liver
- Do not smoke and avoid vaping
- Stay at a healthy weight to protect your liver and heart
- Get regular immunizations recommended by your transplant team
- Avoid herbal remedies and over-the-counter supplements unless your team approves them
Diet and exercise
Eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein. You may need to avoid raw or undercooked foods to prevent infection. Ask your transplant dietitian for specific advice. Gentle exercise like walking, swimming, or cycling is safe and helpful once your doctor says it is okay. Start slowly and build up gradually.
Mental health and emotional wellbeing
A liver transplant is a big life event. You may feel anxious, depressed, or overwhelmed at times. It is completely normal. Your mood can also be affected by some transplant medicines. Talk to your healthcare team about how you feel. They can connect you with counseling or support services.
Prevention
You cannot prevent the original liver disease that led to the transplant, but you can help prevent complications after transplant. Taking your medicines, attending follow-up care, and living a healthy lifestyle make rejection and infection less likely.
Vaccines
Talk to your transplant team about which vaccines are safe for you. Live vaccines are usually avoided after transplant, so it is important to check before getting any vaccine, including flu, COVID-19, and others.
Screening programmes
You will have regular blood tests, imaging, and skin checks. These help catch problems early, such as signs of rejection, infection, or reduced kidney function.
Complications
If left untreated
- Rejection, which can damage the new liver
- Serious infections
- High blood pressure, diabetes, or high cholesterol
- Kidney disease
- Certain types of cancer, especially skin cancer
Long-term outlook
Most people live many years after a liver transplant, and many return to a normal quality of life. With careful medical care, a healthy lifestyle, and good support, the outlook is hopeful. It is a lifelong journey, but you will not have to manage it alone.
Find support
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Related conditions
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 31, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.