The liver transplant recipient: what you need to know for long-term care.

In general, long-term treatment of hypertension, diabetes, and obesity after liver transplantation is similar to that for the general population. Measure bone density within the first year after transplantation. Treat osteoporosis with standard agents. Joint replacement surgery appears safe in this group of patients. Resume standard screening for malignancy 2 to 3 years after transplantation, and repeat at intervals similar to that used with the general population. Given the high risk of skin cancer, transplant recipients should wear sunblock (SPF >40) and have routine dermatologic examinations. Patients should wait at least 2 years before considering pregnancy and use barrier-type methods in this period. Vaccinate patients against hepatitis A and B, influenza, and pneumococcus. Avoid live vaccines.