After Pediatric Liver Transplant Surgery

Step Four: Staying Healthy After Transplant

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Following transplantation, the liver transplant team will closely monitor your child’s recovery. We are your partners throughout the transplant journey -- from your child’s evaluation through their recovery, ongoing care, and transition to adult care.

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Follow-Up Appointments

Monitoring Recovery

The first few months after being discharged from the hospital, your child will need to be seen frequently -- up to several times a week -- by the transplant team. During each visit, doctors will draw blood from your child, weigh them, and check their vital signs. Then the transplant team will perform a physical exam, review medications, and discuss your child’s recovery and progress. You may meet with other team members such as a dietitian or a social worker. If your child needs to see another specialist, we can help coordinate appointments to avoid multiple visits. Over time, your child’s visits will occur less frequently.

Staying Local

For the first few months after surgery, if you do not live in the area, you may choose to stay close to Duke Children's Hospital and Health Center. Your transplant coordinator and social worker can help you make lodging or transportation arrangements based on your family’s needs. Many of our families stay in the Ronald McDonald House, while others prefer an apartment or hotel room, which may be available at a reduced rate.

Our Locations

Liver transplant surgery is performed at Duke Children's Hospital and Health Center. Pre- and post-transplant appointments take place at our liver transplant clinic within Duke Children's.

Staying Healthy After Transplant

Managing Medications

Your child will take many medications after surgery. They will take lifelong immunosuppression drugs to prevent organ rejection, fight infection, and treat side effects of the immunosuppressants. Over time, your child will take fewer medications at lower doses. Your transplant team will help you understand the purpose, dose, and potential side effects of each medication.

Preventing Rejection

Rejection occurs when your child’s immune system identifies the donor liver as a threat and begins to attack it. Rejection of a transplanted liver can happen days or years following transplant, but in most cases, it can be reversed if detected early. That’s why it is important for your child to get regularly scheduled bloodwork, attend all follow-up appointments, and for you to be on the lookout for signs of rejection -- including fever, yellowing of the eyes and skin, and fatigue.

Because many children do not show any signs of rejection, your child will have frequent bloodwork to check their liver function and levels of immunosuppression medicine. If liver lab results are abnormal, they may need a liver biopsy to check for rejection. Episodes of rejection are usually treated with an IV steroid and sometimes a second anti-rejection drug. Your child’s normal immunosuppression medicines may also be adjusted.

Is Your Child Ready for an Evaluation?

If you want to make an appointment for a pediatric liver transplant evaluation for your child, contact us. Our team can help with next steps.

Monitoring Vital Signs

To help your transplant team track your child’s progress and adjust their medications, you may be asked to record your child’s fluid intake and output, weight, blood pressure, and temperature and to bring these records to your follow-up appointments. Changes in vital signs may indicate a need for medical attention. 

Avoiding Infection

Although immunosuppression medications help prevent rejection of your child’s new liver, they also make them more likely to get infections, such as colds, the flu, or other viral illnesses. Your child can lower their risk for infection by consistently washing their hands, avoiding crowds and people who are sick, and by wearing a mask. The transplant team will talk with you about if and when your child should get vaccines. They will let you know what is safe. 

Life After Transplant

Ongoing Support

As part of our program, you and your child will meet other families who have gone through similar experiences. The transplant team is also here to support you. For instance, we can coordinate behavioral health counseling to help you and your child cope with the stress of managing a chronic illness. These services are available throughout your child’s recovery until they make the transition to adult care.

Formal Transition to Adult Care

Liver transplantation is a lifelong commitment. That’s why we educate and communicate with your child beginning at age 12. They will learn everything they need to know to stay healthy and manage their condition as they make the transition to adult medical care, which usually takes place between the ages of 18 to 22. Your child will learn how to schedule appointments, where to fill their prescriptions, how to get help with insurance questions, and more. 

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

This page was medically reviewed on 09/01/2023 by