Liver Transplant Surgery

When you arrive at Duke University Hospital, you and your caregivers will meet with members of your transplant team, including your surgeon and anesthesiologist. A chest X-ray, EKG, a urine test, and blood tests will be done, and you will be prepared for surgery.  

Before a liver is accepted for a transplant, it is thoroughly evaluated. Donor livers must be free of damage and disease. There are times when the organ is not healthy or is otherwise not a good fit, and the transplant has to be canceled. This is known as a “dry run.” If this happens to you, we will continue to care for you and prepare you for transplant surgery in the future. Our goal is to give you a liver that will last a lifetime.

Your surgeon will make a cut across your abdomen, just below your rib cage. When the donor liver arrives in the operating room, your diseased liver will be taken out and replaced with your new liver. The gallbladder attached to the donor liver will be detached to ensure that it does not cause problems with your new liver, and your gallbladder will also be removed. The surgery lasts from six to eight hours; your caregivers will be kept informed of your condition. 

After your transplant surgery, you will be taken to the Surgical Intensive Care Unit (SICU), where your doctors and nurses will monitor your condition and make you comfortable. You may still have a breathing tube in your mouth from surgery, a small tube in your nose that drains your stomach contents, and other support devices. These will be removed as you recover. Your condition will be constantly evaluated in the SICU. Physical therapists will help you exercise your legs to reduce the risk of blood clots. The hospital team will determine when you can walk after surgery. This may be as soon as 24 hours after surgery. 

When you are ready to leave the SICU, usually after one to three days, you will be transferred to the transplant surgery stepdown unit, where you will continue to regain your strength. You will have daily blood work done to check your liver function and to make sure your medications are at the correct level. An in-hospital transplant coordinator will provide training and resources on required medications, follow-up appointments, exercise and diet, protecting yourself from infection and rejection, and more. You will meet with other members of your transplant team, including your doctors, pharmacist, social worker, and dietician. You may be able to leave the hospital within ten days after your transplant, but you may need to remain in or close to Durham for another month for frequent follow-up visits.

Step 4: After Transplant