Reaching My 5-Year Post-Liver Transplant Checkup Milestone

My sister and I recently drove to Pittsburgh to visit my transplant surgeon for my annual post-liver transplant checkup. I hadn't thought much about it before I got there; it was just another yearly checkup. The staff congratulated me on the 5-year milestone, and I realized it truly was an achievement.

5 years is a significant milestone

It is a milestone if only because there is mortality data available. According to Mayo Clinic, “about 75 percent of people who receive a liver transplant live for at least 5 years after surgery. That means that for every 100 people who receive a liver transplant for any reason, about 75 live for five years and 25 die within 5 years.”¹

Most people consider reaching this milestone as an indicator that the patient and the healthcare team have worked together to effectively manage the recipient's health. Surviving 5 years is a strong indicator that the patient will live with continued health and a good quality of life.

There are many reasons why a person may not make it to their 5-year anniversary. The patient can experience liver rejection, and adherence to medication regimens is crucial. Continuing the schedule of regular post-liver transplant checkups can influence whether a patient reaches this milestone.

The role of immunosuppression

Immunosuppression can be difficult due to side effects, the need to be diligent with medication timing, and infections that may occur because of immunosuppression. Some patients find it difficult to be compliant. Others have difficult challenges based on their reactions to medications and their level of health at the time of the transplant. Patients with multiple health challenges may be overwhelmed, and their bodies are dealing with a lot, which affects their health status.

Life post-liver transplant has its challenges

Patient adherence to protocol, including keeping up with every scheduled post-liver transplant checkup, is only one part of the outcome. I have been compliant, but I do feel grateful that I have (mostly) maintained my health. When I look back on these years and listen to others who have walked down this road, I realize what a challenge being a liver transplant recipient is, and I am grateful.

Understanding the long-term risks

Within the statistics about survival post-transplant is the fact that there is a wide range of ages in the population documented. Some of us were very ill prior to transplant, and some of us were relatively healthy. Some of us have comorbid (or more than one) significant disease processes. Still, lack of compliance with our immunosuppression regimen is the number one cause of organ failure. Hopefully, all of us have changed the lifestyle issues that contributed to our disease, and some of us are better at avoiding infection than others.

After 5 years, we can face long-term problems, such as an increased risk of malignancy, especially if there was cancer in the liver prior to transplant. Unfortunately, some patients develop diabetes or other renal problems from their immunosuppression. Many are faced with the need for a kidney transplant. This is one more reason why staying committed to your post-liver transplant checkup schedule remains so important, even years later.

Decreasing my immunosuppressant medication

My doctor cut one of my immunosuppressant medications in half. He changed the dosage and decreased it by 50 percent. Your physician may or may not make changes to your medications at your 5-year post-liver transplant checkup. I was very happy about that change. It lowers my risk of complications from that immunosuppressant. But I also feel a little bit better now being off that medication. He also discontinued one of my blood tests, the one that tests for cancer, and that makes me a little bit nervous because I did have liver cancer prior to the transplant. But I have been tested for 5 years, and there has been no return of hepatic cancer.

Finding gratitude post-liver transplant

When I returned home, a friend gave me a gift recognizing my survival to the 5-year point. It was very helpful to have outside validation that reaching your 5-year post-liver transplant checkup milestone is an achievement. Those 5 years feel like a lifetime looking back on them, but I have been able to find some gratitude and joy in the achievement.