Liver Transplant Surgery

Step Three: Receiving Your New Liver

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During liver transplantation, your diseased liver is removed and replaced by all or part of a donor liver. Because liver transplant surgery is a complex procedure, you need a highly experienced transplant team. Duke’s outcomes, including one-year liver survival rate, are consistently among the best in the nation. This is the case even though we accept very sick people into our program.

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Before 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.

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.

The Liver Transplant Procedure

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. 

Our Locations

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

Recovery in the Hospital

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

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 once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 10 pediatric specialties by U.S. News & World Report for 2024–2025.

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