Our Approach

The Evaluation Process

Evaluation

Due to the known damage caused by alcohol and drugs, patients being considered for liver transplant must be drug- and alcohol-free for at least 6 months before evaluation. We often do blood and urine tests for alcohol or non-prescribed drugs.

Additionally, these diagnostic studies and more exams may be required before you are accepted as a candidate for a liver transplant:

• Complete history, physical and blood work
• Chest X-ray and heart tests
• Social work evaluation
• MRI of liver, abdominal organs and vessels
• Colonoscopy
• Endoscopy
• Testing for tuberculosis
  
• Mammogram and Pap smear for women
• Dental exam
• Evaluation by a neuropsychologist
  

You’ll meet with one of our transplant hepatologists, as well as a transplant coordinator, social worker and others. This is a good time to ask any questions. After the initial evaluation, we will schedule additional required testing.

Sometimes we schedule testing to be performed the day of the first clinic visit. This may require that you stay overnight in the area to be able to complete the required testing. You can expect the first visit to our clinic to take most of the day. You should bring your family member or your support person with you for this first clinic visit. We will want to meet with them as well as you. Having a successful transplant will only be possible if you have the support of family or friends who are willing to commit to helping you through this process.

• Liver patient education handbook for pre-transplant (PDF)

Recommendation

We will recommend a prescribed program of care, including findings on the suitability of transplant and next steps in the process.

Waiting for An Organ

Waiting List

All appropriate candidates are presented to the Selection Committee, which considers placement on the national waiting list. This takes place after all testing and evaluation is done. 

The wait list for transplant is managed nationwide by a federally regulated, non-profit organization called the United Network for Organ Sharing (UNOS). UNOS uses a complex set of factors to ensure distribution of organs is handled fairly.

Liver transplant candidates are assigned a status code, referred to as MELD/PELD scores (Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease). Livers are offered to those with the highest medical urgency based on these scores.

The waiting time for a liver varies. It may only days, a month, or it may take a year or two. It is based on the acuity or level of illness of the candidate.

The Effect of Living Donation on Wait Time

A liver may come from a living or deceased donor. Living donors, who donate a portion of their liver, are often family members or sometimes close friends. The benefits of living donation include a shorter waiting time and the ability to schedule surgery to accommodate the needs of the recipient and donor.