Living with liver transplant living
Informed by recognized medical guidance
Overview
A liver transplant is surgery to replace a diseased liver with a healthy one from a donor. Many people who have a liver transplant go on to live active, fulfilling lives. 'Living with a liver transplant' means taking care of your new liver, managing medicines, and staying connected with your healthcare team.
Key facts
- The liver is the only organ in the body that can regrow, so a donor's liver can grow to normal size in your body.
- You will need to take medicines that calm your immune system for the rest of your life to prevent rejection.
- With regular check-ups and a healthy lifestyle, many transplant recipients live for many years after surgery.
Liver transplants are not everyday operations, but they are well-established. Thousands are performed around the world each year, and survival rates have improved greatly in recent decades.
People who receive a liver transplant usually have advanced liver disease that cannot be treated in any other way. This can happen in adults and children, at any age, depending on the cause of the liver problem.
Symptoms
- Trouble breathing or shortness of breath
- Severe pain in your belly or chest
- High fever with shaking chills
- Vomiting blood or passing black, tarry stools
- Sudden confusion or fainting
- ⚠Fever even if mild
- ⚠Signs of rejection (jaundice, dark urine, pale stools)
- ⚠Redness, swelling, or pus at the incision site
- ⚠Persistent vomiting or diarrhea
- ⚠New pain or tenderness over the liver area
Common symptoms
- Fever (temperature above 100.4°F or 38°C)
- Pain, redness, or swelling around your incision (surgical cut)
- Yellowing of your skin or the whites of your eyes (jaundice)
- Unusual tiredness or feeling generally unwell
- Nausea, vomiting, or loss of appetite
- Dark urine or pale stools
Symptoms in children
- Being unusually fussy or irritable
- Poor feeding or not gaining weight
- Fever or vomiting
Symptoms in older adults
- Confusion or drowsiness
- Falls or unsteadiness
- Reduced interest in eating or drinking
Causes
Main causes
- Cirrhosis, or severe scarring of the liver, from conditions like alcohol-related liver disease, non-alcoholic fatty liver disease, or hepatitis B and C.
- Acute liver failure, where the liver fails quickly after an infection, drug reaction, or other cause.
- Liver cancer that is only in the liver and cannot be removed by surgery.
- Bile duct diseases and inherited conditions like Wilson disease or alpha-1 antitrypsin deficiency.
Risk factors
- Not taking immunosuppressant medicines exactly as prescribed
- Exposure to infections (like flu or COVID-19) without protection
- Drinking alcohol, which can damage the new liver
- Smoking or using other tobacco products
- Being very overweight or not being physically active
When to see a doctor
See a doctor urgently if:
- Contact your transplant team right away if you have any signs of rejection or infection, such as fever, jaundice, or severe abdominal pain.
Book a routine appointment if:
- You will have regular follow-up appointments for the rest of your life. Your transplant team will tell you how often you need blood tests and check-ups — often every few weeks at first, then less often over time.
Diagnosis
After a liver transplant, your healthcare team will check you closely for signs of rejection (when your immune system attacks the new liver). Rejection is diagnosed with blood tests, imaging studies, and sometimes a small biopsy.
Tests that may be done
- Blood tests to check liver function and measure levels of immunosuppressant medicines
- Ultrasound scan to look at blood flow to and from the new liver
- Liver biopsy — taking a tiny piece of liver tissue with a needle, under local anaesthetic, to check for rejection
What to expect at your appointment
These tests are routine and usually painless. They help your team catch any problems early, before they become serious. You will get clear instructions from your team about how often you need them.
Treatment
Treatment after a liver transplant is not about curing the liver — it's about protecting it. You will take medicines to stop your immune system from attacking the new liver, and you will need to make some healthy lifestyle changes.
Self-care at home
- Take your medicines exactly as prescribed, at the same time each day, and never stop them without talking to your transplant team.
- Wash your hands often and avoid close contact with people who are unwell.
- Keep your surgical cut clean and dry.
- Stay up to date with recommended vaccines and check-ups.
Medical treatments
Your doctor will prescribe immunosuppressant medicines (also called anti-rejection medicines). These calm your immune system so your body accepts the donor liver. You will need to take these for life. Your team may adjust the doses or combine different medicines depending on how you are doing. You may also receive medicines to prevent infections, such as anti-viral or anti-fungal medicines, especially in the first few months.
When is surgery considered?
In rare cases, a transplanted liver may fail, and a second transplant is needed. Your team will explain what happens if this occurs.
Living with this condition
A liver transplant changes your routine. You will have regular appointments and blood tests, and you'll need to be careful about infections. Many people find that after the first few months, life feels quite normal again.
Lifestyle tips
- Do not drink alcohol at all — alcohol can damage your new liver.
- Don't smoke or use tobacco; ask for help if you need it to quit.
- Avoid raw or undercooked foods that may carry germs.
- Protect your skin from the sun, because immunosuppressant medicines increase your risk of skin cancer.
Diet and exercise
Eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein. Limit salt to help control blood pressure. Ask your transplant team for a diet plan if you need one. Gentle exercise like walking, swimming, or cycling is good — start slowly and build up as you feel stronger.
Mental health and emotional wellbeing
Feeling anxious or low after a transplant is common. You've been through major surgery, and it's normal to have mixed emotions. Talking to a counsellor, joining a support group, or simply sharing your feelings with loved ones can help. If you feel very down or have thoughts of suicide, reach out to a mental health professional right away.
Prevention
Liver transplant rejection cannot always be prevented, but you can lower your risk by taking medicines exactly as prescribed, keeping appointments, and living a healthy lifestyle. Protecting yourself from infections is also key.
Vaccines
Vaccines are important after a transplant. Some live vaccines are not safe when you take immunosuppressant medicines, so always ask your transplant team before getting any vaccine.
Screening programmes
Regular blood tests to check your liver function are a form of screening. You may also need regular skin checks because of the increased risk of skin cancer.
Complications
If left untreated
- If rejection is not treated, it can damage the new liver and lead to liver failure.
- Infections can be serious if they are not caught early.
- Untreated complications can increase the risk of needing another transplant.
Long-term outlook
The outlook after a liver transplant is generally very good. Most people survive and many live for decades with a healthy liver. While taking medicines for life and attending check-ups are essential, a transplant can give you a new chance at a full, active life.
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.
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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.