It should always be remembered that liver transplantation is only the beginning of a new and healthy life. To maintain your health and ensure the long-term success of the transplant, the following recommendations must be carefully followed.

Medication Use After Liver Transplantation

After the transplant, you will be prescribed various medications—some for lifelong use and others for temporary support. Immunosuppressive medications are essential to prevent liver rejection and must be taken exactly as prescribed. Their doses may be adjusted based on blood test results. Therefore, when attending follow-ups, you should arrive on an empty stomach and avoid taking medication before blood testing.

Some medications will be discontinued over time, but no medication should ever be stopped or changed without consulting your physician. You must also inform any medical facility you visit outside the transplant center that you are a liver transplant recipient. Smoking is strictly prohibited as it damages blood vessels and increases cancer risk, while alcohol consumption is not allowed due to its toxic effects on the liver and interference with medication levels.

Post-Liver Transplant Check-Ups

Liver transplant patients require lifelong medical supervision. Check-up intervals vary over time as follows:

• 2 days after hospital discharge
• Weekly for the first month
• Every 15 days between the 1st and 3rd months
• Monthly until the end of the first year
• Every 2 months after the first year if no complications occur

Patients from other cities or countries must stay in the transplant city for at least 1 month after surgery. If an external biliary drain was placed, it will be removed approximately 4 months after the operation.

Infection Prevention After Liver Transplantation

Because lifelong use of immunosuppressants weakens the immune system, infection prevention is critical:

• Wear a mask for at least 6 months and avoid crowded places or visitors at home.
• Avoid close contact with sick individuals. Report symptoms such as fever, sore throat, cough, weakness, nausea, or urinary burning immediately to your physician.
• Maintain strict hand hygiene and avoid contact with animals or gardening for 6 months.
• Do not use public toilets, saunas, Turkish baths, or swimming pools for at least one year.
• Avoid eating food prepared under unhygienic conditions and do not consume offal-based products.

Nutrition After Liver Transplantation

Post-transplant patients should follow a low-sugar, low-fat, and low-salt diet due to the side effects of medications. Fresh vegetables and fruits must be washed thoroughly, and meat should always be well cooked. A balanced diet with protein, carbohydrates, and fats is recommended. Patients with diabetes or hypertension should continue their dietary discipline both before and after transplantation.

Due to immunosuppressive therapy, blood sugar levels may increase, and 15–20% of patients may develop permanent diabetes. If necessary, endocrinology consultation will help maintain blood sugar balance. Grapefruit, pomegranate, and their juices must be avoided because of potential drug interactions.

Returning to Work

Patients who experience no complications may return to work after 3–6 months, depending on the nature of their job and overall health. Clearance for returning to work is determined based on clinical and laboratory evaluations.

Daily Activities After Transplantation

During the first 3 months, lifting items over 5 kilograms should be avoided. Climb stairs slowly, refrain from strenuous exercises, and avoid any activity that increases abdominal pressure. Driving should be avoided for the first month. Standing showers are allowed early on, but the surgical area should not be rubbed or irritated.

Sexual Life and Pregnancy After Transplantation

Sexual activity may be resumed approximately 6 weeks after surgery if there are no complications. In the presence of vaginal infection in the partner, precautions must be taken, and medical advice should be sought. For pregnancy, patients should wait at least 1 year post-transplant, and conception should only be planned under medical supervision, since immunosuppressive therapy adjustments are necessary during pregnancy.

Expected Lifespan of the Transplanted Liver

Although acute or chronic rejection can occur at any time, strict adherence to post-transplant instructions allows for a long and healthy life. Regular medical follow-ups and proper medication use significantly increase the expected survival time of the transplanted liver.

Important Points for Liver Donors

The remaining portion of the liver in donors regenerates within 3 months and resumes full function. During donor surgery, the gallbladder is also removed along with part of the liver. Donors are examined 1 week after discharge and followed monthly thereafter.

To prevent hernia formation, donors should avoid lifting heavy objects or performing strenuous physical activities for at least 1 year. Liver donors live normal, healthy lives and experience no reduction in life expectancy. When seeking medical care outside the transplant center, donors must inform healthcare providers of their donor status.