The thought of going under the knife for your transplant surgery can send you reeling into all of the what-ifs.  Knowing some of what you can expect will help alleviate some of the anxiety surrounding the surgery itself.  On top of that, it will give you more confidence in a positive outcome.

Once again, I will be discussing things specific to liver transplant in this article.  I just don’t feel comfortable sharing information about a transplant I have not gone through myself.  I’ll share statistics about other transplants (with links to where you can see the information), but aside from that, I’ll be speaking from personal experience.

With that said, if you are reading this and have had (or will have) a transplant other than the liver, please leave a comment or send me a message.  I’d love to have a guest writer on here to talk about other transplants.

Transplant Surgery Statistics

We’ve talked about statistics before.  Survival statistics (take that 20% survival rate!) that can bring you to your knees long before you have the opportunity to freak out about having transplant surgery.  The ones we’re going to talk about today are the pretty, shiny ones that show how great your odds are when it comes to a transplant.

Let’s get straight to the good news, shall we?  The one-year survival rate is the primary marker across the board for transplant survival (although three- and five-year rates are common as well).  Each hospital is going to have its own statistics and you can look them up on the OPTN website (or ask them directly, they can provide them).  According to OPTN, the national one-year averages look like this (2008-2015):

• Heart – 91%
• Intestines – 81%
• Kidney – 97%
• Liver – 91%
• Lung – 88%
• Pancreas – 92%

You can also find data for multiple organ transplants as well, although I didn’t include them here.  Now, I don’t know about you, but going from a 20% survival rate to 80% or more is pretty encouraging to me.

Going Under the Knife-Transplant Surgery Specifics

Here’s where we get into the nitty-gritty of a liver transplant surgery.  Surgery time, incision, drains, pain, and recovery.

I remember looking up information while I was waiting for my transplant just trying to understand as much as I could.  I’m a planner and so eliminating as many unknowns as possible is kind of my M.O.  I’m one of those people who would watch a procedure online (if I could) so that I’d know what was happening even if I was under anesthesia.  Maybe I should stop saying that out loud.  People might start to think I’m some kind of nut or something.

The thing is, no two surgeries are the same.  Just like no two people are the same.  There are standards and commonalities of course, but there will always be something that will be different.  I should mention that in addition to your liver transplant, your gallbladder will also be removed.  The gallbladder is used kind of like a back up in bile production.  This means that if you eat a greasy burger or a bunch of fried food after transplant, you won’t feel great.  Your dietician can help you with adhering to a low-fat diet to help with this.

Transplant Surgery Time

Surgical time can take anywhere between 6 and 12 hours.  Much of this depends on your specific situation.  Things like previous abdominal surgery, scar tissue, or the size of the non-functioning liver (or liver being transplanted) can all cause surgery to take longer.  Again, every case is different, but most will be completed in this time frame.  You’ll be asleep through the whole thing though, so this is really more for the caregivers and loved ones who will be sitting in a waiting room.

What About the Scar?

This seems to be one of the first questions people ask me when they learn they need a liver transplant.  Is there a scar?  How big is it?  Most liver transplant incision scars are referred to as a “hockey-stick.”  However, if the surgeon needs more space to get your old liver out or to get the new one in, you may find yourself with the “Mercedes” scar.

Mine is more hockey-stick-esque (although more rounded like a crescent moon or something).  It starts just below my sternum (that little space between your ribs on your chest) and curves down below my rib cage on the right to about 5 inches from my side.  Even after 7 years, you can still see it pretty clearly.  At the top of my scar, I have a small section that is shaped like a heart (Mr. Graft Diaries likes to say that’s because it’s my lifeline), which I think is pretty cool.  I have several little lines on either side of the scar where stitches used to be and three round-ish shaped scars where drain tubes once were.  I call those my bullet holes.  You will also have IVs and central lines that may leave small scars behind as well although mine are barely noticeable.

Wait, Did You Say Drains?

Part of what happens when you have your transplant surgery is you will also have some drains inserted.  Some people may have biliary drains to aid in the drainage of excess bile.  However, JP (Jackson-Pratt) drains are common practice in surgery.  These are tubes with small, egg-shaped balls at the end that help remove fluid from the surgical site.

Why are drains important you ask?  Well, let me just tell you.  If you’ve ever injured yourself, you know that the body increases blood flow and with that comes excess fluid around the injury site.  This is the body’s way of trying to speed up healing.  In surgery, this fluid increases and could stick around for a longer period of time.  While the body is doing what it does naturally, in this case, too much of a good thing is a bad thing.  This excess fluid is the perfect breeding ground for infection and it can also actually prolong healing in the area.  Your team will be closely monitoring the output of these drains to be sure everything is healing as it should.

Drains do not stay permanently and are removed simply by removing a stitch and gently pulling out the tube.  I know, I know.  It sounds painful.  There is some discomfort involved in this, but I wouldn’t go so far as to call it painful.  A transplant volunteer who visited me after my surgery suggested something to make this process a little easier, and I’ll pass that on to you too.  As your care team prepares to remove the drain, inhale deeply and then exhale slowly as the drain is removed.  Afterward, you won’t be walking around with drains all over so I’d consider that a pretty big win.

Transplant Surgery Pain

I have an entire article devoted to this very thing, so I’ll keep it brief here.  I won’t lie to you, it hurts.  A lot.  But, you will be given pain medication and every day will be a little better than the last, so you’ll get through it.  You can help things along by following what your doctors and nurses tell you to do as you recover.  Nurses will want you to get up and moving pretty frequently.  They aren’t trying to be mean and they don’t enjoy watching you in pain.  Nurses understand the good that comes from moving and how much it will help you, so be nice to them.  They have your best interest in mind.

What Does Recovery Look Like?

This is another one of those questions people ask often.  At the risk of sounding like a broken record, it depends on the person and situation.  Generally speaking, you can plan to be in the hospital for 7-14 days and recover at home for 4-6 weeks.

While in the hospital, you’ll be getting up to walk around several times a day.  There will be exercises to do to keep fluid from building up in your lungs.  You’ll be working on getting plenty of nutrition.  Physical and perhaps even occupational therapists will visit to prepare you for going home.  These are all things that are important pieces of your recovery in the hospital.

Let me back up a little bit to talk about getting nutrition.  After you’ve been under anesthesia, many people report having little to no appetite and that food tastes like cardboard.  Even though you may not want to eat, it is incredibly important that you do.  You’ve just undergone a major surgery and physical trauma.  Your body is going to need all the nutrition it can get to help heal.

If you find yourself not wanting to eat, try to think of your food as fuel.  Or medication.  Eventually, your taste will come back and you can enjoy the flavor of food again.  In the meantime, eat for healing.  And to avoid a feeding tube because, YUCK!

When you go home, you’ll have some lifting and exercise restrictions (which should come as no surprise), but other than that, it’s just a matter of pain management and keeping up with getting some walking in every day.  It won’t be long before you find you are feeling much more like yourself (or a version of yourself that might need a nap or two during the day).

Congratulations!

You’ve done it!  You made it through the long and hard journey and received your transplant.  Pat yourself on the back and say thank you to everyone who helped get you there.  While you’re at it, say a special thanks to your donor and their family.  You have a whole new life thanks to them.