In 1996, Westchester Medical Center performed the first liver transplant in the Hudson Valley. Since then, the Liver Transplant Program has performed more than 400 transplants.
The Liver Transplant Program is staffed by an experienced and caring team of physicians, transplant coordinators and nurses that provide complete medical treatment before, during and after a transplant. In addition, our transplant team at Westchester Medical Center, includes specialists in Hepatology, Oncology, Radiology, Pediatrics, Cardiology, Nutrition, Nephrology etc., to ensure that each patient receives the best possible care.
The Transplant Center is located in the Behavioral Health Center, A Wing-Lower Level, 20 Hospital Road on the campus of Westchester Medical Center.
Call the Liver Transplant Program at 914.493.8916.
What are the risks and complications associated with liver transplant surgery?
In addition to the risks common to all forms of major surgery, there may be technical difficulties in removing the diseased liver or implanting the donor liver. One of the major risks for the patient is not having any liver function for a brief period. Immediately after surgery, bleeding, poor function of the grafted liver, and infections are major risks. The patient is then carefully monitored over their lifetime for signs of rejection of the liver.
The most common side effects to a liver transplant are a result of the drugs used to prevent rejection. Each medication has its own unique set of side effects. You should talk to your doctor about any side effects associated with your medications.
What are common conditions seen in liver transplant patients?
- PTLD is Post-transplant lymphoproliferative disorder. A tumor-like swelling in the lymph nodes seen in immunosuppressed patients. It can become cancerous if not treated.
- PCP is Pneumocystis carinii pneumonia, a type of pneumonia seen in immunosuppressed patients which can be prevented with medication.
- Jaundice is a yellowing of the eyes and skin caused by excess bile. Can be a sign of rejection, bile duct obstruction, or liver disease.
Should I call my doctor if I catch a cold after surgery?
Should you experience cold symptoms such as cough, sore throat, or nasal discharge, see your doctor. It may be difficult to tell if you have a cold or a more serious infection requiring antibiotics. You may need a chest x-ray, throat cultures, or other tests to determine treatment. Remember to inform your coordinator of any new prescriptions.
Keep track of your temperature, and remember to call your coordinator if it goes to 101° F (38.5° C) or is 100° F (37.80 C) for 24 hours.
Check with your coordinator before taking any over-the-counter cold medications. Many over-the-counter cold medications contain pseudoephedrine which can interact with Prograf/Neoral/Gengraf.
Before you leave the liver transplant unit, your nurse will fill out your medication schedule and post transplant prescription. It is important for you to review and record your medications as soon as possible, so that you are familiar with them when you are discharged from the hospital. Post liver transplant, one should always keep a list of medications in your wallet.
Your transplant coordinator will meet with you to review all aspects of care before you are discharged home. It is our hope to provide as much information as possible to answer your questions and concerns, however this in no way attempts to replace the ongoing relationship you have with your transplant team and primary physician. There is a great deal to learn about your post liver transplant care. As always, you should seek medical advice for any new symptoms, changes in condition or concerns.
Generally you will need to be seen in the Liver Transplant Unit twice weekly for the first three weeks after the liver transplant surgery, then weekly for several weeks, and then every two weeks. Clinic days are Monday and Thursday. You will need to have your blood drawn at the Transplant Phlebotomy Office first in the University hospital before you take your morning dose of PROGRAF/ NEORAL/ GENGRAF. You should then come over to the Liver Transplant Office and sign in to be seen by your transplant coordinator. Expect to be in the office for about four hours the first time you come in. As time goes on, the wait will be less and you will be able to have labwork done closer to home in the future.
Although the initial weeks of liver transplant recovery can be challenging, most patients are able to return to a normal or near-normal lifestyle in 6-12 months after a successful liver transplant. This is also the approximate time it takes to get back to fairly vigorous physical exercise. Routine follow-up after the liver transplant recovery period consists of monthly blood tests and measuring of blood pressure. Annual or semi-annual checkups are also conducted by the transplant team.
For faster liver transplant recovery, transplant recipients should avoid possible exposure to infections as their immune system is depressed. Illness should be reported to the doctor immediately and medicine taken only under medical supervision.
For most women, life after a liver transplant can include a normal pregnancy and birth, although they have to be monitored carefully because of a higher incidence of premature births. Mothers are advised against nursing babies because of the possibility of immunosuppressive drugs being ingested by the infants through breast milk. Patients should maintain a balanced diet and are advised to lower their intake of salt to help reduce water retention in the body.
Rejection is your body's way of recognizing your donated liver as foreign and attacking it. If liver transplant rejection is diagnosed and treated early, it can usually be reversed.
Elevated laboratory results can indicate a possible rejection but only a liver biopsy can determine if you are having a liver transplant rejection. Other factors can cause your liver enzymes to be elevated. For this reason, treatment of liver transplant rejection should be managed only by the transplant team.
The transplant surgeons may ask you to come to Westchester Medical Center for a biopsy to diagnose and treat you promptly. Your symptoms and test results will help the surgeon make this judgment. Your surgeon will determine whether these tests can be done at a hospital near your home or whether you will need to return to Westchester Medical Center. If the surgeons think that it would be life threatening to delay diagnosis and treatment, they will ask you to return to Westchester Medical Center immediately.
We recommend that you have a plan in place should you need to return to Westchester Medical Center for this or other reasons. Such a plan would include having extra money for travel expenses and transportation and making arrangements for the care of your children, other dependents, or pets while you are away.
Some important facts about rejection:
- Having rejection does not mean you will lose your liver.
- You may feel perfectly well while you are having rejection.
- Rejection may be acute, occurring suddenly.
- Rejection may be chronic, occurring slowly over time.
- If not treated, rejection will worsen.
- Rejection can occur at any time.
To increase the odds in your favor for early detection of rejection:
- Have your lab tests as recommended by the transplant team.
- Assure that your transplant coordinator receives the results promptly.
- Take your medications as prescribed.
- Report signs of rejection immediately.
Signs of liver transplant rejection include:
- Elevated liver numbers - total bilirubin, SGPT (ALT), SGOT (AST), GGTP.
- Abdominal pain or tenderness.
- Dark-colored urine.
- Light colored stool.
- Yellow eyes.
- Yellow skin.
- Ascites (fluid in the abdomen)
For patients who also received a kidney transplant, signs of rejection include:
- Decreased urine output
- Increased blood pressure
- Weight gain
- Fluid retention
- Increased creatinine level
- Pain or tenderness near transplanted kidney
Thomas Diflo, MD – Chief of Intra-Abdominal Transplant and Hepatobiliary Surgery
Gregory Veillette, MD – Surgical Director, Liver Transplant, Transplant Surgeon
David Wolf, MD – Medical Director, Liver Transplant, Transplant Hepatologist
Richard Rosencrantz, MD – Medical Director, Pediatric Liver Transplant, Pediatric Transplant Hepatologist
Roxana Bodin, MD – Transplant Hepatologist
Hiroshi Sogawa, MD – Transplant Surgeon
Abhay Dhand, MD – Director, Transplant Infectious Diseases
Rajat Nog, MD – Transplant Infectious Diseases
Bettina Knoll, MD – Transplant Infectious Diseases
Martha Gamboa, MD – Transplant Psychiatrist
Leanne Forman, MD – Transplant Internist