Asian Centre for Liver Diseases & Transplantation

Discharge and After:

Liver transplant is a major surgery and as with most complicated surgery, your support system, i.e. your family, friends or caretaker, play an important part in your recovery. You may be extremely weak and experiencing various unpleasant medication side effects. The first three months following your transplantation are the most difficult. Your body is adjusting to the "new" liver and all the medications needed to maintain your health. By the time of your discharge from the hospital you will be able to care for yourself, with some minor restrictions. The transplant team doctors, nurses and coordinator will carefully prepare you for discharge and discuss in detailon:

The care of the incision and the T-tube;
Physical therapy;
The post transplant file;
Medications;
Special dietary needs;
Do’s and don’ts;
Follow-up visits;
When to seek immediate medical attention
Returning to work;

Ensure that your family, friends or caretaker are with you throughout the day and night. Your incision area need to be cleansed diligently everyday. You may need assistance getting up and moving around. If it is determined that you need extensive physical therapy, you may be discharged to the physical rehabilitation centre to help you regain strength. Exercise is critical to mental health and physical well-being. Physical activity helps to decrease muscle weakness, a side effect of the immunosuppressant Prednisolone. Your physiotherapist will provide you with a progressive program that will help you without causing strain or serious injury.

In the post-transplant file, you will have to monitor and note your temperature and blood pressure twice a day. You will also have to take your weight every morning and record it into the file. You will need to bring your post-transplant file to our clinic for every follow-up visits. As you progress, the frequency of blood and lab tests will decrease. Depending on your condition at the time of your discharge, you would be scheduled to visit our Intensivist, Dr Lee Kang Hoe, twice a week for the first month.

If you are a foreigner and have returned to your country, and have your own physician to care for you, the blood tests will have to be done every fortnight. Please ensure that you or your family members fax/ email us your report to our clinic so that we can keep up to date with your results. If our doctors find any irregularity in your lab report or indication that you would require medical attention, you may have to return to Singapore and have your condition stabilised. If your test results are good, you will need to do lab tests once a month for the first year. During the second year post transplant, if your results are stable (within normal range), you will be required to make quarterly (every 3 months) follow-up visits for lab tests and scans and being reviewed by our doctors. From the third year post-transplant and thereafter, a bi-annual (every 6 months) visit to Singapore for routine physical examinations. Female recipient must remember to have a pap smear and mammogram once a year after transplant. Male recipient will need a testicular and prostate examination and a PSA (prostatic specific antigen) test if they are over age 50. These exams are performed by your family doctor as cancer screening procedures.