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Life after liver transplant

Infection prevention

Just as important as keeping a child and family members healthy before transplant, it is important to keep a child and the family healthy following a transplant. Some simple infection preventions guidelines are listed below:

  • Wash hands often and before and after meals
  • Wash hands after using the restroom or changing a baby’s diaper
  • Keep hand sanitizer available when hand washing is not an option
  • Stay away from family members who are sick
  • Use a face mask while in public and avoid large crowds
  • Stay up to date on immunizations including the influenza (flu) vaccine
  • Notify the child’s transplant team if the child develops an infection or cold/flu symptoms while on the wait list. The child may need to temporarily become inactive on the wait list while ill.

Activity restrictions

The transplant team will provide the child and family with any activity restrictions after discharge. It is usually advised for the child to not perform any strenuous activity or to lift anything greater than 5 pounds. The incision should be closely monitored for any signs of infection including redness, drainage, swelling or tenderness. The child should avoid swimming in lakes, oceans or swimming pools until the incision has healed completely.

The physical and occupational therapy departments will share any recommendations for exercises that should be continued at home after discharge.

Transplant medications

After a child has a liver transplant, several medications will be ordered to prevent rejection, infection, and other medical conditions. Though a rejection is more likely to occur in the first few weeks following transplant, an organ rejection can happen at any time. The transplant recipient will be on the anti-rejection medications for life. The transplant team will discuss all potential side-effects and precautions associated with the medications. The team will instruct the parent/caregiver about when it is important to report any side effects to the team. No over-the-counter medications or food supplements should be started without discussing with the care team.

When to contact the transplant team:

  • Fever of 101°F or higher
  • Cough, runny nose, congestion
  • Changes in heart rate or blood pressure
  • Redness, drainage, swelling or tenderness at incision
  • Decreased activity, tiredness and fatigue
  • Decreased appetite
  • Headache
  • Upset stomach/nausea
  • Jaundice/ yellowing of eyes or skin
  • Fluid retention
  • Medication issues (missed dose or difficulty filling prescription)
  • Prior to dental work (antibiotics may be needed)


Following transplant surgery, the child’s body may try to reject the new liver. The immune system may see the new liver as a threat and will try to attack it. The anti-rejection medications are used to help prevent this complication.

Some common symptoms of rejection may include:

  • Fever of 101°F or higher
  • Jaundice/ yellowing of eyes or skin
  • Dark urine
  • Light-colored stools
  • Itching
  • Swollen or sore belly
  • Extreme tiredness or fatigue
  • Feeling grouchy or irritable
  • Headache
  • Upset stomach or nausea

Living with a liver transplant

Living with a liver transplant is a lifelong process and it is important that the child maintains close contact with the transplant team. Medication compliance can be difficult, especially during the teenage years. Our support services can help these children and their families to find ways to best adapt to these requirements. The team will also help transition the child to an adult provider once it is appropriate and will collaborate with the adult team to help ensure success for the patient.

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