Department of Transplantation Dept. of Transplantation

19. Follow-up Appointments

You are expected to follow a strict schedule of appointments in the Department of Transplantation during your recovery. These visits are to check you are recovering as expected, to ensure your new liver is not malfunctioning, and for early detection of complications.

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Appointments with Lahey

Appointment Schedule

These visits will be frequent at first, but will be scheduled further apart as your recovery progresses and your condition stabilizes. A typical schedule would be as follows:

Month 0 – 1: Weekly visits

Month 1 – 3: Visit once every two weeks

Month 3 – 6: Monthly visits

Month 6 – 12: Visit once every two months

Month 12 +: Visit twice per year

You can expect your transplant team to monitor you for the rest of your life. During visits, the physician may need to conduct blood tests, some X-rays, or a liver biopsy. They will also track your kidney function, since some medications you’ll be taking may inadvertently affect your kidneys. In between clinic visits, we’ll ask you to go to a laboratory near your house to have blood drawn so we may track your body chemistry. These blood tests will tell us volumes about your liver function, your immunosuppressants, and whether any complications are arising.

Scheduling Conflicts

We’ll try to work the appointments around your schedule. We appreciate your compliance with these arranged meeting times. If for any reason you cannot make it to an appointment, please give us a call as early as possible so we may make new arrangements. We also appreciate having your latest contact information; if you change your address or phone number, please let us know.

Gender-Specific Concerns

Women

  • Have an annual pap-smear
  • Perform a breast self-examination once a month to check for breast cancer. The recommended time to do this is 1 week after your period.
  • We recommend you delay pursuing pregnancy for 1 year after liver transplantation. This is to avoid damage to the surgery area, overstressing your body, and premature births. Talk to your transplant team before pursuing pregnancy; some anti-rejection medications may be harmful to a developing fetus.
  • We recommend you use a diaphragm with spermicidal gel, or a condom for birth control. Birth control pills are not recommended until a few months post-surgery. Talk to the transplant team for the appropriate time to use birth control pills.
  • If you use tampons, use the smallest size needed, change them frequently, and don’t use one overnight to avoid infection.
  • If you are over 50, you may need to have a colonoscopy with your doctor.
  • Some women may have stopped having periods due to their liver disease. Their periods may return after receiving a transplant. Be aware that you'll need to take birth control if this is the case and you don't want to become pregnant.

Men

  • Perform a testicular self-examination once a month to check for lumps.
  • If you are over 40 years of age, have a physical examination once per year, and ask to be screened for prostate cancer.
  • Talk to your doctor before planning to conceive a child, since some medications might lead to birth defects.
  • If you are over 50 years old, talk to your doctor about having a colonoscopy performed.
  • There’s a rare possibility that erectile dysfunction may occur. This may be due to diminished blood-flow to the area after surgery, but is usually self-correcting. Ask for a visit to our urologist if you are concerned.

Appointments with other Physicians

Primary Care Physician

Your primary care physician should continue your routine physical check-ups. Make sure he or she is aware that you’ve had a liver transplant so that any drugs that are prescribed don’t interfere with your immunosuppressants.

Dermatologist

Your anti-rejection medications also increase the likelihood of getting skin cancer, so we recommend you see a dermatologist once a year. This rule should be observed even if you never had skin problems before the transplant.

Dentist

Make sure you maintain good dental hygiene to avoid getting an oral infection; brush your teeth after every meal, floss carefully once a day, and visit your dentist once every 6 months. As with other physicians, tell your dentist which anti-rejection medications you’re taking before going through any dental work. You will also need to take antibiotics before having any dental work done.