A Doctor’s Advice for Life After Liver Transplant

Credit: Adobe Stock/manyakotic

After a liver transplant, nourishing your body becomes an essential part of recovery. As Pranab M. Barman, M.D., a gastroenterologist and liver transplant specialist at UC San Diego Health, explains, recovery isn’t just about the surgery — it’s about building healthy habits that support long-term healing. Eating balanced, easy-to-digest meals, staying active and leaning on your care team are key steps on the road to wellness. This week’s featured recipe — a Crustless Cauliflower Quiche — is a simple, protein-rich dish that supports recovery and energy without being heavy on fat or sodium. It’s the kind of meal that pairs perfectly with Barman’s philosophy: take recovery one day, and one healthy choice, at a time.

Crustless Quiche With Cauliflower

Ingredients

• 2 teaspoons olive oil or butter
• ½ cup chopped onions
• 5 large eggs
• ½ teaspoon salt-free seasoning
• ½ cup low-fat milk, rice milk or soy milk
• 1½ cups chopped cauliflower
• ½ cup shredded low-fat cheddar cheese
• 1 teaspoon paprika

Instructions

1. Preheat oven to 375°F. Lightly oil an 8-by-8-inch casserole dish or 9-inch pie pan with olive oil or butter. Spread onions evenly in the dish and place in the oven while you prepare the other ingredients.
2. In a small bowl, beat eggs, salt-free seasoning and milk with a whisk.
3. Remove dish from oven with mitts and spread cauliflower and cheese evenly. Pour egg mixture over cauliflower, onions and cheese. Sprinkle with paprika.
4. Bake for 30 minutes, until cauliflower is cooked, and casserole is golden brown.

For patients and families, what does the liver transplant process look like from surgery through recovery?

Pranab M. Barman, M.D.: For patients, it is certainly a big and challenging surgery. It is considered one of the biggest surgeries anyone can go through, lasting about 6 to 8 hours on average. Generally speaking, after this, the patient recovers for 1 to 3 days in the intensive care unit and then spends another few days in the hospital. The average length of stay is about 7 to 10 days in total.

However, recovery continues at home or local lodging. It requires meticulous attention to detail with respect to medication plans, dietary instructions and physical therapy. While every patient is different, these are the three pillars of the at-home recovery process. As it is a big surgery, I, oftentimes, advise patients that the full recovery process can take up to 6 months, but how it should be viewed is on a day-to-day basis. Essentially, each day, we should be striving, as a team, to make one thing better than the day before. That might be related to sleep, appetite, learning medications … the list goes on. It is a long recovery, but with a good attitude and a good team, it can be an easy recovery as well.

What are some of the most important things people should know about caring for their health after receiving a liver transplant?

PB: An important item to remember is that transplant patients are going to be taking a lot of medications after transplant, and oftentimes their pretransplant medication list is simply replaced by another one. These transplant-related medications can certainly cause side effects and unintended consequences, and monitoring for these is vital — by both the patient and the transplant team. Certainly, those side effects will need to be addressed and managed if they come up.

Additionally, following an overall healthy approach to life is a key to success. This includes eating well (patients certainly have an appetite again), exercising and staying active (when physically able to) and paying attention to other medical conditions and considerations. This last part would include things like making sure that diabetes, hypertension, etc. are well managed; patients receive their vaccines and age-appropriate cancer screening tests and are overall well connected to the medical system outside of the transplant clinic.

These are things that will take priority later on, after transplantation, usually beyond the 6-month mark, but serve as a reminder that the transplant is only a part of the overall picture.

Many patients feel anxiety or stress after a transplant. What advice do you have for coping with them?

PB: Lean on your team. Your family, friends and transplant team are there to help you succeed and, in the beginning, you won’t be able to do everything by yourself. Rely on your teammates to help you through the hardest part of the recovery and slowly ease your way back into your way of living and managing your transplant by yourself.

Focusing on small successes (as suggested above, “each day better than before”) will allow you to not lose sight of the big-picture recovery and not get overwhelmed or disheartened by what may seem like a slow process.

What does long-term follow-up care look like, and why is it so critical for transplant success?

PB: As hinted above, long-term care focuses on staying connected with the transplant team to ensure that your transplant remains healthy and successful. Having a good primary care provider that you have a good relationship with is also very important to ensure that you maintain that overall healthy life that you are striving to achieve after transplant.

What resources or support systems would you recommend for patients and families navigating life after transplant?

PB: There are many support groups out there involving transplant professionals and, also, transplant recipients who are very eager to tell their story. At the University of California, San Diego, we have a support group that meets regularly and allows patients from all parts of the process (pre, in evaluation, and post) to be involved and share their perspectives. This can sometimes be very helpful to gain another perspective, one that is more real-world rather than textbook or “what should happen."

The American Liver Foundation (ALF) has a support network for liver transplant recipients and more information about organ donation. ALF also has peer-to-peer support through their Caring Connections program. If a patient just needs questions answered, please call ALF’s FREE helpline at 1-800-GO-LIVER (800-465-4837) Monday through Friday from 9 a.m. to 5 p.m. ET. These types of resources can be very effective for navigating the entire process from start to finish.