Life After Liver Transplantation


“Congratulations on successfully going through your liver transplant. This was surely not one of the easier journeys of your life, but we will be walking along with you and your family during this recovery.

For a quicker and healthier outcome, it is important that you learn to take proper care of yourself. Remember, you are the most important member of the liver transplant team. It is only your active participation that would lead to a successful recovery.” said Dr Tan Kai Chah.


Liver Transplant Recovery

After a liver transplant, it is important for transplant patients to care for their new organ, which includes possible lifestyle changes, regular exercise, healthy diet, taking medications and going to follow-up medical appointments regularly.

Recovering from a liver transplant can be a long, slow process, but most people will eventually be able to return to most of their normal activities and have a good quality of life.

It can take up to a year to fully recover, although the patient will normally be able to start gradually building up their activities after a few weeks.

Follow-up Appointments
Regular follow-up is essential after a liver transplant. The frequency of clinic visits and check-ups is usually twice a week immediately after discharge. The frequency gradually decreases and adjusted, depending on patient progress and doctor’s advice.

Risk of organ rejection is highest in the first 60 days after the transplant, so it is crucial to attend the clinic visit regularly.

Anti-Rejection Medication
One of the most important responsibilities patients will have after the transplant is taking their medication as they are prescribed. The success of the transplant is dependent on a patient who took the medications regularly as advised.

It is important for patients to learn about the medication before they leave the hospital:

  • The name of the medications that they are taking
  • The dosages or quantity
  • When and how often to take in a day
  • Why is he/she taking the medications
  • Possible side effects to look out for

Liver transplant recipients must take the anti-rejection medications for the rest of their life. Immunosuppressant or anti-rejection medications are medications that help prevent the body from rejecting the new liver. Anti-rejection medications affect the patient immune system; people who have a transplant are at a higher risk for infection.

Additional Information:

  • If patients who miss a dose of anti-rejection medication, he/she must tell the transplant coordinator who will advise on when to take the next dose. Patients do not double the dose to make up for the missed doses.
  • Patients on anti-rejection medications should not eat certain foods, such as pomelo and grapefruit, as these can affect the levels of the anti-rejection medications. Similarly, never take any new medications, including traditional or over-the-counter medication, without informing the transplant team as certain medications may interact and affect the absorption of the anti-rejection medication.
  • Patients should tell their dentist, doctor or surgeon that he/she is taking anti-rejection medications before undergoing any dental or medical procedure.


Recognising Rejection and Infection
A major concern after transplant surgery is the risk of organ rejection. Rejection happens when the patient body stops accepting the new liver. When this happens, patient immune system “attacks” the new organ, as if it doesn’t belong in the body. This triggers the patient body to make white blood cells and antibodies which harm to the new liver.
If signs of rejection are detected and treated early, the condition can be reversed.
Signs of rejection:

  • Fever
  • Dark, tea-colored urine
  • Yellowish eyes
  • Jaundice (yellowish skin and eyes)
  • Pale or clay–coloured stools
  • Chills, aches and unexpected tiredness

A patient who undergoes liver transplantation has an increased susceptibility to infections due to the anti-rejection medications. We advise patients to practice good personal hygiene, avoid improperly cooked food and avoid close contact with persons with active infection.
The patient should seek early medical attention in case of any new symptoms.
Signs of infection:

  • Unexplained tiredness (fatigue)
  • Fever
  • Redness or white spots on tongue or mouth
  • Incision or wound redness, swelling, cloudy or foul-smelling discharge
  • A persistent cough with or without shortness of breath
  • Flu-like symptoms
  • Pain or burning sensation during urination
  • Diarrhoea

    The patient should always check with the doctor or transplant coordinator before getting any vaccination. Patient SHOULD NOT receive any live vaccines. The live vaccine could cause serious health complications because the patient may develop a virus that is being immunized against. It is recommended that patients should avoid close contact with children who have received live vaccines within the last one month.

    Liver Transplant Aftercare

    Diet and Nutrition
    Eating a well-balanced diet is especially important after a liver transplant to help the patient recover and keep them healthy.

    A dietician will advise patient before they are discharged on how to maintain a healthy balanced diet which consists of a variety of foods as well as on the safe food handling.

    Instruction on how to minimise the risk:

    • Wash hands before and after handling food
    • Avoid raw or partially cooked food, especially meat, shellfish, seafood and eggs
    • Wash all fruits and vegetables before cooking and eating them
    • Avoid eating from salad bars, buffets or other shared dishes due to possible contamination by others and unsafe food temperatures
    • Avoid unpasteurized milk and cheese
    • Lower salt and sugar intake
    • Try to drink about 2 litres of boiled water daily
    • Avoid foods that may be prepared in unclean environments


    Routine Activities and Exercise
    Exercise and physical activity should be a regular part of patient life after a liver transplant to continue improving their overall physical and mental health.

    A physical therapist will teach and help patient exercises to recover and avoid complications. Soon after the transplant, the patient should start walk as much as they can. Then, depending on progress, the patient can start incorporating more physical activity into their daily life. Walking, bicycling, swimming, low-impact strength training and other physical activities you enjoy can all be a part of a healthy, active lifestyle after transplant. But be sure to check in with your transplant team before starting or changing your post-transplant exercise routine.

    Annual Screening
    Beyond complications related to the new liver, metabolic syndrome, cardiovascular disease, renal dysfunction, and malignancies are leading causes of morbidity and mortality.

    As such, liver transplant patients should undergo a detailed health screening yearly so that your physician can supervise and manage your health properly.

    Psychological and Emotional Health Support
    The journey of the liver transplant process is difficult, both mentally and physically. The level of anxiety and difficulty varies for each transplant recipient. Always talk to your doctor or the transplant team whenever you are suffering from any kind of physical unease or emotional stress.


    As a liver transplant recipient, you should learn the ways to take proper care of yourself and your new liver. Download “Life After Liver Transplant Guidebook”.

    As a patient with us, we care about what you think. Feel free to provide us with valuable feedback to help us improve the care of our patients. We wish you a fast recovery and good health. Enjoy your new lease on life!

    For enquiries, please contact:

    Asian American Liver Centre
    6A, Napier Road
    Gleneagles Hospital, Annexe Block #02-37
    Singapore 258500