Two doctors standing in a hospital hallway discuss an organ transplant patient’s case.

A Keck Medicine of USC liver transplant surgeon discusses how transplant specialists and community physicians must work together to support transplant patients long-term.

More Americans are living with transplanted organs than ever before. Surgeons performed nearly 50,000 transplants in 2025, in part because of continued growth in living organ donation. 

With treatment advancements, patient survival has also increased substantially in recent decades. While averages vary depending on which organ was transplanted, data shows many patients live for decades post-transplant. 

This equates to millions of people who require lifelong care to ensure their transplanted organ continues to function properly. To help each patient maintain overall good health, their local provider is equally as important as the transplant team.

At the USC Transplant Institute, part of Keck Medicine of USC, transplant specialists are committed to working collaboratively with community physicians to help transplant patients stay on top of their health and monitor them for any concerning changes, says Robert Selby, MD, a hepatobiliary and pancreatic surgeon who specializes in liver transplants at the USC Transplant Institute.

The role of the transplant doctor after surgery

Transplant patients must take immunosuppressive medications for the rest of their life to prevent their immune system from rejecting the organ as foreign. At the same time, finding the correct balance of immunosuppressive medications is critical so that the patient isn’t overly vulnerable to serious infections. 

Selby says the patient’s transplant team is responsible for administering the immunosuppressive regimen and making dosage adjustments when needed. 

“Early on, the focus is on preventing rejection,” he explains. “As treatment continues, we want to avoid any negative consequences of immunosuppression, such as vascular disease or kidney toxicity.” 

For the first year after surgery, the patient’s care largely stays with the transplant team as they monitor for rejection and make adjustments to the immunosuppressive regimen. 

The frequency of check-ups will vary depending on the patient’s unique needs. But as a general guideline, transplant doctors may see patients weekly for the first few months after transplant. 

Follow-ups will gradually be spaced out longer — to several weeks or months between appointments — and eventually to just annual visits. 

The role of the community physician after organ transplantation

Many patients travel long distances for their transplant. The USC Transplant Institute sees patients from across the state and the country and is one of just a handful of specialized programs offering living-donor liver transplants.

And even for local patients, their regular care will be under the supervision of their community provider once they’ve recovered from surgery. 

“Community physicians need to be aware of particular warnings signs to watch for in these patients,” Selby says.

Rejection can manifest in a wide range of symptoms, including fatigue, fever, headaches, nausea and stomach discomfort. Immunosuppressive toxicity may lead to tremors, diabetes, hypertension and kidney injury.

Community physicians monitor all of this via routine labs and bloodwork. Any changes should be shared with the patient’s transplant team.

“Sometimes, we can adjust a medication based on those lab results,” Selby says, “without the patient needing to come in and see us.”

Maintaining a collaborative approach after organ transplantation

Cooperation between the transplant team and the local physician is vital for providing high-quality care for each patient. As Selby notes, as the number of transplant patients continues to rise, specialized programs like the USC Transplant Institute rely on community physicians to help support this growing population over the long-term.

“We’ve transplanted thousands of patients; it’s the population equivalent of a small-size city,” Dr. Selby says. “And most of them live normal lifespans now. To incorporate and monitor all those patients, we need the community physicians.”

He emphasizes that local providers shouldn’t hesitate to reach out to the transplant team at any time with questions.

“We really depend on personal relationships between the referring doctors and our specialists here in the transplant program,” Selby says.

“We want referring physicians to feel comfortable texting and asking us, ‘Hey, I have a patient whose creatinine level is rising. What should I do about this?’ We have an army of post-transplant coordinators who are always available for phone calls and emails.” 

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Organ Transplantation: The Importance of Physician Collaboration After Transplant