Everyone recuperates from liver transplantation differently. Depending on your child's condition, he or she will be hospitalized for two to eight weeks following the transplant. Most children stay within the San Francisco Bay Area for two to six weeks after the transplant and then are referred back to their primary care doctor and referring physician. Our social workers will assist you with temporary housing.

Once your child has returned home, we work with your primary doctors to ensure that your child receives optimum care, both for the liver transplant as well as issues related to normal growth and development.

Laboratory blood tests are obtained twice a week following transplantation; the frequency of blood tests is gradually reduced over time. You will be asked to call in test results to the transplant office. You will then be notified about any adjustments in your child's medications.

Potential Complications

Complications can occur with any kind of surgery, and patients undergoing organ transplants may face additional complications. The life-threatening disease that created the need for your child's transplant may affect the functioning of other body systems. Other problems, such as rejection of the new liver, may also occur.

Some possible transplant complications and medication side effects include:

• Hemorrhage — One function of the liver is to make chemical components used to help blood clot, called clotting factors. When a liver fails, the ability to produce clotting factors is impaired. To correct this problem, your child will receive blood products before and after surgery. We expect that the new liver will start working very quickly to help prevent any excessive bleeding, but your child may need to return to surgery to control the bleeding, particularly if it occurs within the first 48 hours after transplant.
• Thrombosis — If a blood clot forms in a vessel leading to or from your child's liver, this may injure the new liver. Your child will receive special anticoagulation medication to prevent this. This is a serious complication that may require a second transplant.
• Rejection — Your child's immune system protects him or her from invading organisms. Unfortunately, it also views the new liver as foreign and will try to destroy it in an attempt to protect your child. This is known as rejection. To prevent this from occurring, your child must take special immunosuppressive medication for the rest of his or her life.
  
  Rejection can be diagnosed early by performing weekly liver biopsies during the first few weeks after liver transplant. Although rejection is common, with early diagnosis and treatment the situation can be controlled in more than 95 percent of cases.

Immunosuppressive Medications

These drugs decrease your child's resistance to foreign bodies, such as the new liver. Your child will need to take these medications for the rest of his or her life or the liver will be rejected. Immediately after surgery, the dosages will be high since the probability of rejection is greatest at this time. Dosages will be lowered quickly to smaller amounts if there are no signs of rejection.

The medications have side effects, which are usually dose-related. Most people experience the most side effects in the beginning when medication dosages are high. As the dosage is lowered, these effects will probably lessen. Side effects may occur in some patients and not in others.

The medications your child will take for rejection also impair his or her ability to fight off infections. Your child will be given medication to help prevent infections but you also will need to use caution and avoid contact with people with infections, especially during the first three to six months after transplant.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.