Diet after liver transplant
You will probably find that you have a better appetite after transplantation than you did before the surgery. Some of the weight gain is also due to the immunosuppressive medications – particularly prednisone. However, for around a third of people after transplant, this is significant (over 10kg or 1.5 stone).
To stay at a healthy weight, it is sensible to reduce your consumption of simple carbohydrates such as food and drink high in sugar. Eating complex carbohydrates such as cereals, vegetables, whole grain pasta, bread, rice and potatoes is a healthier choice. It is also helpful to restrict how much fat you eat, not just to limit weight gain but also to help control your cholesterol which can be a particular challenge when taking some anti-rejection medications.
It is also important to eat sufficient protein to enable your wounds to heal and to build muscle. You may be advised to eat roughly 80g a day of protein, spread over several meals if possible. Protein is found in meat, poultry, fish, eggs, nuts and beans.
Your transplant centre can give you specific dietary advice and refer you to a dietician for any specific problems you have.
When can I go back to my usual routine?
Having a liver transplant is a major operation and people need time to recover. How much time depends on the individual and it can vary from six weeks to six months before people are ready to take up normal activities again. It is a good idea to reduce the length of time you do various activities, such as work, school or exercise, so you can build up your strength. You will probably find that you get tired more easily and it is important to be able to rest whenever you need to.
When can I take up exercise?
Taking up a healthy lifestyle with exercise built-in is an important part of your recovery from a transplant. However, it is important to build up your levels of activity gradually and it will take time to build your strength and endurance. You should avoid strenuous exercise for the first couple of months and check with the transplant centre that this will not cause problems. It is important not to lift heavy items until your wound has healed and for at least the first two months after transplant. Contact sports, such as boxing, should generally be avoided.
What about travel?
You will be advised not to travel long distances away from your transplant centre in the early weeks. After this, it depends on your health and where you are travelling to. Some destinations may put you at increased risk of infection, from anything such as food poisoning bacteria to malaria and you may not be able to receive some of the necessary prevention mechanisms such as live vaccines. It is best to seek medical advice about whether travel to these destinations is advisable at all.
When you travel, always take contact details for your transplant centre with you so you can contact them for advice when you are away.
Sensible precautions such as not travelling if you feel ill, seeking prompt medical advice if you are unwell when away (and telling them you have had a liver transplant), and taking a written list of all your medications and doses are very important.
It is important to remember that your travel insurance will not cover you (or anyone travelling in your party) for health problems that arise, cancellation, or the need to return home early, unless you havespecifically briefed them about your medical history and they have agreed to cover. If you do not have health insurance, it is a good idea to check the cover that might be provided to you in an emergency and whether they have any reciprocal agreements for healthcare, such as participation in the European Health Insurance Card scheme.
Will I be able to have a normal sex life after liver transplantation?
As soon as you feel ready! Transplantation can affect sexual function – men can find that it can take a couple of months for everything to work normally again. Certain medications, too, can have an effect. If you have any problems or concerns you should talk about these with your transplant team when you come to clinic.
Women are not recommended to use oral birth control pills immediately after transplant, and for both men and women, it is important to use contraception because conceptions must be carefully planned if you have had a transplant (see below).
Both women and men have a higher risk of contracting sexually transmitted diseases (STDs) if on immunosuppresants, so take extra care and practice safe sex.
Can I have a baby following liver transplantation?
If you are considering trying for a baby, speak to your transplant team for advice. Some medications (particularly mycophenolate mofetil (CellCept)) can harm the unborn child, so it is important that they review and possibly adjust your medication regime before you get pregnant. It is vital that you do not stop taking your immunosuppressants when you become pregnant without speaking to your transplant team. In general it is thought that you should wait at least 12 months following your transplant before attempting to conceive.
The good news is that many women have become pregnant and have had healthy children after transplant. Perhaps unsurprisingly, complications are more common in liver transplant recipients than in the general population. As a result, such pregnancies should be followed by a multidisciplinary team involving both obstetric and transplant specialists.