The Children's Hospital of Philadelphia
Our Liver Transplant Program — What to Expect After the Transplant

Narrator: Sooner than you think, it will be time to leave the hospital and go home. The first month after the transplant is a busy time. You will be visiting the Liver Transplant Clinic often, and you may have to have bloodwork done between clinic visits. It's also a time to adjust to being out of the hospital environment to taking care of your child at home and to getting life back to normal.

After the transplant, especially in the first year, you will have to be on the lookout for signs of rejection. Early signs may include fever or abdominal pain. Later signs are jaundice or a yellow color of the skin and eyes, and changes in stool or urine color.

Your child will also need to take medicines to prevent infections, which are more likely to occur because the immune system is being suppressed. Many of these will be stopped by about one year after the transplant. Your physician may also prescribe high blood pressure medicine or a stronger anti-rejection medicines as needed.

When children are discharged from the hospital, they are generally taking two medications to prevent rejection and six to eight medications to prevent side effects from the first two. Over the first few months, one of the rejection medications will be gradually discontinued, and the second will be decreased. The other medications can then gradually be stopped so that by the end of year one most children take a single medication twice a day.

You will receive instructions on how to administer your child's medication once you're home. It is important that you learn why each medication is being taken and follow the directions exactly. It will help you if you develop a plan and follow the same routine every day. Never let your child's medications run out. Always refill them at least a week ahead of time. And if you have any problems with refills, call your transplant coordinator right away to get the problem sorted out.

If you noticed any changes in your child's health, a persistent cold or a fever, especially in the first few months after leaving the hospital, call your transplant coordinator. Don't give your child any medications that haven't been prescribed by the transplant team without checking first.

Living with a transplant is a lifelong process. Children with transplants take immunosuppressants and other medications to prevent rejection for the rest of their lives. Regular checkups and follow-ups will continue into their adult years. They'll have to learn how and why to take their medications on their own as they grow up and become more independent. But that's about it. Almost all kids who receive of a liver transplant are able to live normal lives with very few restrictions.

They are expected to return to a full range of age-appropriate activities. In fact, after the transplant, they often find that they can do most things better than before because they don't feel sick all the time. In general, children who have undergone liver transplantation are able to participate in school, work, and can expect to have children of their own.

Every child is unique, and every transplant is different. Research to improve the process, much of it conducted right here at the Children's Hospital of Philadelphia, is constantly under way. Today, we have every reason to believe that children who have liver transplants can live long and healthy lives. They can get back to the business of being kids again.