After Your Transplant

Is there a definitive list of foods to avoid after transplant?

Each transplant centre has slightly different guidelines regarding what you can and can’t eat. Your transplant coordinator/dietitian will guide on you their recommended list of foods to avoid or take care with.  Initially, post-transplant most patients will be asked to follow a high protein and high energy diet to help their body recover. You are encouraged to eat a healthy balanced diet.

Standard advice usually includes:

• Avoiding of shellfish, sushi and any raw fish; any who are bottom feeders in the sea such as mussels, clams and whelks
• Ensuring all dairy products are pasteurised
• Avoiding soft cheeses such as brie, camembert, blue-veined cheeses and some goats cheeses.  Cheeses are ok if they have been cooked (to kill off any bacteria)
• Ensuring eggs are cooked thoroughly. Do not eat any food from recipes using uncooked eggs i.e. homemade mousse, eggnog, mayonnaise or ice-creams/sorbets
• Avoiding pate and meat paste
• Avoiding grapefruits, Seville oranges, pomelo fruits and pomegranates as they can interfere with your immunosuppression medication. You must also avoid foods which contain these foods such as Seville marmalade

Following good food safety practices especially around food storage and preparation is important.  When eating out you need to take more care; buffet food is often discouraged due to the spread of germs (unless you’re first in the queue!), ensuring all food is cooked thoroughly, checking if the cheeses on the cheeseboard are pasteurised or any dishes which may be home-made and contain raw egg or unpasteurised dairy products.  If in doubt, either avoid it or ask but don’t let it put you off eating out and enjoying food.

The hospital dietitians and transplant coordinators will be able to answer any queries you have. Don’t be afraid to ask.

Can I drink alcohol after liver transplant?

Many people choose to abstain as they worry it may affect their new liver. However, some will choose to have small amounts of alcohol or the occasional glass or two. Check with your own doctor to be sure.

It is highly recommended that you do not smoke after you had a transplant. Smoking carries many health risks (in particular cardiovascular disease and respiratory problems). Furthermore, in patients who had a liver transplant, smoking is associated with an increased risk of developing hepatic artery thrombosis (blockage of the blood support to the new liver), biliary complications and cancers (i.e. lungs, skin, mouth).

If you recover well after the transplant, you may be driving as soon as 6 months after your transplant. However, this depends on how well you are generally, on your ability to do sudden movements (i.e. sudden stops), on the level of pain you may experience, etc. Always discuss this with your doctor: it’s a matter of safety for yourself and other people.

How soon you return to work depends on how your new liver functions and any complications you may have. A liver transplant is a major operation and it takes time to build up your regular activities and get back to work. Some people return in a matter of months, others much longer. In some cases, you may start, for instance, with a part-time activity.

In 2018 a small poll was carried out on our Facebook group which asked post-transplant PSC patients how long it was before they returned to work:

• 6 returned to work within 3-4 months
• 3 returned to work within 4-5 months
• 8 returned to work within 6-8 months
• 3 returned to work over 8 months
• 3 returned to work decided not to go back to work.

There is no set rule about when you should be able to resume work, and everyone is different.

The medications you take post-transplant can increase your chances of developing skin cancers.  You will be advised to cover up with a hat and suitable clothing, avoid the midday sun and wear a high factor sunscreen SPF 30-50+ with good UVA and UVB cover. We all need a bit of vitamin D so some exposure is fine if you’re careful and cover up. Having a transplant doesn’t mean you have to spend the rest of the summer hiding indoors or in the shade.

Most transplant centres advise people not to travel out of the UK until at least six months after their transplant, and not outside Europe until after a year.

If you are unsure about travelling or have complications whilst you are away from home, check with your doctor or transplant coordinator. It’s also a good idea to make sure you know where the nearest medical centre is at your destination.

Please be aware that travelling to some countries may be restricted post-transplant, especially if certain vaccinations are required, and you haven’t already had those.

Our travel section includes information about the IBD passport. This is useful to read even if you don’t have IBD because it gives information on travelling when you take immunosuppressants.

You will always have your scar but it will usually fade over time and become less noticeable.

This video was taken from Professor Michael Heneghan's presentation to primary sclerosing cholangitis patients at our London 2019 Information Day. This video covers:

• Pregnancy in PSC
• Gallstones in pregnancy
• Cirrhosis and pregnancy
• Transplantation and pregnancy
• Contraception post-transplant

Your transplant experiences

You’ve had your transplant, why not work towards being a world champion? The British Transplant Games take place every year. Aim higher and join the World Transplant Games!

We love to see people who’ve had transplant for PSC take part in Transplant Games. Do get in touch if you’re involved.

Our Facebook group regularly has updates from people who have had transplants for PSC, who go on to enjoy and experience wonderful things - take a look.