After Your Liver Transplant

Step Four: Taking Care of Your New Liver

Liver transplantation can give you a second chance to enjoy a healthy life. Taking care of yourself after you leave the hospital directly contributes to the success of your transplant. Coming to all follow-up appointments, taking your medications as directed, abstaining from alcohol and tobacco products, and practicing other healthy habits help you achieve the best possible outcome.

Ready for an Evaluation?

If you are interested in making an appointment for an evaluation, please ask the provider treating your liver disease to submit a referral.

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Follow-Up Care for Liver Transplant Surgery

You will need to return to Duke frequently for outpatient tests and Liver Transplant Clinic visits during the first month after your surgery. At every follow-up visit, you will meet with members of your transplant team and undergo testing to see how well you’re healing, monitor any medication side effects, and look for signs of rejection.

Your schedule will depend on your progress and concerns. If you live more than an hour’s drive away from Duke, you will need to find temporary lodging for the first month after transplant, when you will visit Duke two to three times per week. Over time, these visits will occur less often, but you will still need to return to Duke for follow-up appointments once or twice a year.

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Preventing Liver Transplant Rejection

Rejection occurs when your body’s immune system begins attacking the new liver. In most cases it can be reversed if detected early. That’s why it is important for you to be on the lookout for signs of rejection, including fever, yellowing of the eyes and skin, and fatigue.

The risk of rejection is highest during first few months after transplant, but because it can occur any time, you will need to take at least one immunosuppression drug for the rest of your life. You will also have frequent blood work to check your liver function and levels of immunosuppression medicine. If your liver function levels are abnormal, you 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 normal immunosuppression medicines may also be adjusted.

Our Locations

Liver transplant surgery is performed at Duke University Hospital. Pre- and post-transplant appointments take place at our hepatology clinic in Durham.

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Your New Routine

One of the most important factors in the success of your transplant is you. Liver transplantation is a lifelong commitment, and it’s important to honor your pre-transplant agreement to stay healthy. Your transplant team understands that adapting to a new routine can be challenging, and we will help you through the process.

Taking Your Medications

After transplant, you will take many medications. In addition to lifelong immunosuppression drugs to prevent rejection, you will take drugs to fight infection and others to treat the side effects of the immunosuppressants. Over time your medical team may approve you to take fewer drugs and lower dosages.

Avoiding Infection

While your immunosuppression medications help prevent rejection of your new liver, they also make you more susceptible to infections, such as a cold, the flu, or other viral illnesses. This risk is greatest when you are on high doses of medication, for instance, when you are being treated for an episode of rejection. You can lower your risk for infection by consistently washing your hands, avoiding crowds and people who are sick, wearing a mask, and getting vaccines as recommend by your doctor.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2025–2026.

Monitoring Vital Signs

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

Honoring Your Pre-Transplant Commitment

Alcohol is toxic to the liver, and it can interfere with your anti-rejection medications. Tobacco use is associated with increased blood vessel and cardiovascular complications after liver transplant as well as a higher risk of cancer. Honor your pre-transplant commitment by abstaining from alcohol and tobacco products and following the diet and exercise recommendations your transplant team made for you.

Seeking Support

As a Duke liver transplant recipient, you are our patient for life. We can provide the resources and support you and your caregivers need -- before and after surgery, and in the years to come. Our transplant coordinators can connect you with people who have gone through the liver transplant process and are always available to answer questions and address your concerns.

Patient Resources

This page was medically reviewed on 06/08/2023 by

Lindsay Y. King, MD, MPH | Hepatologist