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The liver transplant procedure generally takes between four and eight hours. The patient will come to the hospital, often the night before, then go down to the operating room, often for about two hours of anesthesia before the surgery even begins. They then undergo a procedure in which their old liver is removed and the new one is sewn into place in the exact same position. After that, they are taken to the intensive care unit, often with the breathing tube still in place.
After the liver transplant, patients will be in the intensive care unit for two days. After that, they are in the regular part of the hospital for about eight to ten days. They then go home, though they may not feel all the way better for up to three months. After that, they tell me they feel their normal state of good health.
Patients that undergo liver transplantation end up with a large incision that resembles a Mercedes car emblem. It goes beneath the rib cage on both sides and extends upwards. It’s a large incision.
Patients are restored to their normal, healthy quality of life after liver transplant – the way they were, before they got sick. Patients can go out to dinner; they can wear normal clothes. Some patients have even played in the Olympics after liver transplant.
Here at Johns Hopkins in our scientific laboratories, we are studying novel ways to treat Hepatitis C. Hepatitis C is one of our most challenging problems before and after transplant and we are studying new drugs that will help us treat patients after transplant.
We are also studying novel drug therapies which will enable patients to become tolerant of their new organ and thus stop taking their medicines. The medicines, though they are life-saving, have many complications and it’s the holy grail of transplant to be able to stop them at some point after transplant.
The most rewarding part of the experience is seeing how sick the patients are before transplant and then watching them become completely normal after their transplant. I ask them or their family, “What do you like to do?” and they may say, “Go fishing” or “Watch the Ravens game” and I tell them, “You’re going to go fishing again.”
The Johns Hopkins liver transplant program is successful because all the team members work together. There’s lots of experts at Johns Hopkins and we take advantage of all of them. There may be a hepatologist, a dietician, a pharmacist – we all work together to give the patient the best possible care.