Once you have been called in for your liver transplant surgery, it is important for you to have this day planned out ahead of time. How will you get to the hospital? Where do you go? What do you bring?

When you get the call for your transplant, you need to arrive at OHSU South Hospital 9th floor Admitting. You will then go to Unit 4A where the nurses and doctors will prepare you for the surgery. 

The time before the surgery is very busy. A resident, intern, or physician assistant will perform a physical examination and take a complete history. You will need to bring a complete list of all your medications. At this time you will be asked to sign one or more consent forms giving your permission to the surgeons to perform the surgery. 

In addition to the physical, you will receive a chest X-ray, EKG and blood tests. The nurses will start an intravenous line (IV) for antibiotics to prevent infection. Finally, you will need to scrub twice with a special antibacterial soap prior to going to the operating room. When it is time, the nurses will take you to the operating room. Once you are placed under anesthesia, the transplant team goes to work.

Length of surgery

The average length of time for a liver transplant is eight hours and may vary from less than six hours to more than 13 hours. The length of time does not predict the success of the surgery. Patients with a past history of abdominal surgery usually take longer during liver transplant because of old scar tissue present in the abdominal cavity. When the surgery is complete, the surgeons close your incision. The incision is closed on the outside with staples. The staples stay in place for at least three weeks and are removed during one of your clinic visits. 

While you are in surgery, your family and friends can wait in the intensive care waiting area. The operating room nurses may come out during the surgery to give you a progress report. It's helpful to identify one spokesperson when communicating to the nursing staff, who will then pass along information to family and friends.

Surgical Intensive Care Unit (SICU)

You will wake up from the transplant operation in the Surgical Intensive Care Unit. The sights and sounds may seem strange to you. You will be attached to many tubes, IV lines, and monitors. The average length of stay in the SICU is 2 days. This will vary depending on how you respond to the surgery, how quickly you recover from the anesthetic and how sick you were prior to the transplant. When you wake up, you may experience some confusion due to the anesthetic. When you are stable, the doctors will remove some of the monitors, intravenous (IV) lines and tubes, and you will be transferred to the Transplant Unit.  

The Transplant Unit

The average length of stay on the Transplant Unit is 5-8 days. This makes your total hospitalization stay approximately 10 days. This varies depending on your overall post-transplant recovery. After your surgery you may feel many different emotions. Many people feel relief that it is over. It is not uncommon to feel depressed or anxious after the surgery. All these emotions are common and most people feel a little of each. While you are on the Transplant Unit you have some important responsibilities before you can be discharged, including eating, walking, coughing and deep breathing.

The Transplant Team will discharge you when:

• You are physically stable.
• You know your medications and can set up each dose.
• You know your clinic and lab schedule.
• You meet the conditions identified on the discharge review worksheet (reviewed by the coordinators).
• You have arrangements for a place to stay when leaving the hospital.