The recipient stays in the transplant ICU for approximately 5 days and then shifted to room. Most recipients are discharged from hospital within 2 weeks. The recipient and his/her care giver is explained in detail about medicines to be taken after discharge. They are provided with guidance about nutrition/ physical activity/ precautions and necessary do’s and dont’s.
Initially the patient visits twice a week in the clinic and then once a week. Blood tests are conducted twice a week for first few weeks and then weekly blood tests are done. Once stable liver function is achieved, patient can go to home town.
Patients may suffer a loss of appetite in early post operative period after surgery. The appetite slowly improves with time. It is important, however, to follow a high protein diet to facilitate wound healing and liver regeneration. If necessary, the dietician will advise supplements in diet. If patients prefer a certain type of meal or cuisine, they should check with the dietician.
Food instructions:
- Food should be cooked hygienically
- Wash utensils well before cooking
- Wash and cook in clean water
- Use boiled/ filtered water
- Drink plenty of liquids; intake is not restricted, as before transplant
- Salt restriction is not necessary unless one has high blood pressure
- Eat plenty of fresh fruits and green leafy vegetables after washing well and peeling off their skin
- Consume a balanced, low-fat, high protein diet
- Eat foods rich in calcium, such as skimmed milk, cheese, soya, eggs, chicken, fish
- In a few weeks, patients can follow the diet they did before the transplant
Food to avoid
- Avoid deep fried or oily foods
- Do not eat leftover food
- Avoid raw eggs or mayonnaise
- Avoid partially cooked food
- Avoid red meat
- Avoid overripe fruits
- Do not consume expired packaged foods
- If potassium is high, avoid foods such as banana , coconut water, fruit juices/pulp
- If blood sugar is high, avoid sweets and fruits such as mangoes
Activity and exercise
- At the time of discharge, patients are generally allowed active walking and routine activities like bending and climbing stairs. Regular exercise increases energy levels, strengthens muscles, and makes the patient feel more active
- It is common to experience weakness and mild abdominal discomfort at the site of the operation, especially with movements for the first few weeks to months after transplant. Do not postpone exercising because of this. The transplant team should be contacted if the patient has severe discomfort with movements.
- Perform deep breathing exercise to expand lungs and help cough out sputum
- The physiotherapist will teach limb exercises, so that limb muscles are strengthened, blood circulation is increased, and the risk of complications such as venous thrombosis is reduced
- Speak to transplant physiotherapists to progressively increase the level of exercise and optimize the exercise schedule
- Take adequate rest and sleep
- Avoid lifting heavy weights (>5kgs), including babies, or performing abdominal exercises, including weight training and swimming for first three months after transplant.
Post operation wound pain management
You will have patient control analgesia (PCA) for pain control through intravenous after operation. Then doctors and anesthetists will prescribe oral pain killer medications regularly.
Post operation blood checking
After the transplant, you will have blood checking every day. You should follow instructions given by nursing staff and take CNI immunosuppressant like tacrolimus after blood taking. Transplant surgeon or physician will adjust the drug dose as per tacrolimus level in the blood. They will also assess the graft function with regular blood tests.
Post operation diet
After the operation, doctors will advise you to resume a regular diet as soon as possible to obtain adequate nutrition. When you first resume diet, you will experience loss of appetite, nausea, flatulence, or even vomiting. This is probably because the residual effects of anesthesia and slow bowel movement after the surgery. You will recover in a few days and your appetite will gradually improve. We recommend you to reduce the regular meal size and eat between regular meals. Do not get too full and avoid taking a lot of liquid before and after meals. The nurse will arrange you clean diet and drinking water.