About Kidney and Liver Transplant Surgery
When a liver or kidney becomes available, your name will be reviewed along with the others in the United Network for Organ Sharing (UNOS) computerized waiting list. If your illness places you in the highest priority, you will be chosen as the recipient and contacted by the transplant coordinator.
At the Hospital
Once at the hospital, you will be prepared for surgery. It is both an exciting and frightening time, so it is important to have someone with you for support. For kidney transplants, at this point we have to wait for the final blood “crossmatch” which takes about 5 hours to complete. When everything is organized, you will be scheduled for surgery. The surgery is performed under general anesthesia and usually takes between six and eight hours for liver, and about four hours for kidney.
After the surgery, you will be moved to the surgical intensive care unit. When you are awake and able to breathe normally on your own, the breathing tube inserted for surgery will be taken out. All other tubes that were inserted for other medical reasons will be removed gradually over the next several days. Generally, all tubes are usually gone by the time you go home.
You will stay in the ICU where the function of the transplanted liver will be monitored very closely in the first 1-2 days. If everything is working well, you may be moved to the transplant unit after 24 to 48 hours. Right away, you’ll start taking a medicine that dampers your immune system, so it’s less likely to damage the donated organ. You will be watched very closely for any side effects from these medicines.
You will also meet with a pharmacist, social worker, dietitian, and diabetic nurse if you have or develop diabetes. All of these people will contribute to your education and help you learn to take your medications correctly, prevent infections, get appropriate follow up including lab draws and to make the necessary arrangements for your discharge – which, if everything goes well, should be anywhere from 4 to 7 days.
Like all surgeries, there are risks to transplant surgery. These will be discussed in-depth with your transplant team but include bleeding, infection, and wound complications.
Sometimes, after you arrive at the hospital for your transplant, we find that for some medical reason, the surgery may have to be postponed (for example, you may have an infection). The donor liver may also have developed some problem that makes it unsuitable for transplant. Although disappointing, this is a temporary setback and the search for a new liver will continue.