Liver Transplant

Before Liver Transplant

Appointment New Patient Appointment or 214-645-1919

Appointment New Patient Appointment or 214-645-1919

The decision to perform a liver transplant depends on a variety of factors. These include patients’ overall health, the severity of their liver condition, the availability of suitable donor livers, and patient preferences and treatment goals. Our expert team partners with patients and their families to choose the most appropriate treatment.

Evaluation

Time is critical for people waiting for liver transplantation. All patients undergo an expedited transplant evaluation, which takes approximately one week.

The evaluation to determine eligibility for the transplant usually includes:

  • Compatibility tests: Blood typing, tissue typing, and crossmatching to match patients with a liver
  • Comprehensive blood tests: To check heart, kidney, liver, thyroid, and immune system
  • Imaging: Might include a chest X-ray, abdominal ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) scans of the chest or abdomen
  • Pulmonary tests: Such as arterial blood gas tests and pulmonary function tests
  • Colonoscopy: For certain patients, depending on age and medical history
  • Mammogram and pap smear: For certain female patients, depending on age and medical history

Candidates for liver transplant must have:

  • No absolute contraindication to liver transplantation
  • No alternative form of therapy
  • Adequate social support – we recommend bringing your support person with you to each appointment during your initial evaluation
  • A willingness and ability to accept liver transplantation, comply with follow-up care, and cover the costs of transplant surgery and post-transplant care

To help prospective transplant recipients make the most educated decisions about their care, we ensure that they fully understand the proposed course of treatment. We review the potential risks and benefits of the procedures and studies that patients will likely undergo during the transplant process.

If our team believes that a liver transplant is the best treatment option for a patient – and he or she wishes to pursue this option – the patient’s name is added to the national United Network for Organ Sharing (UNOS) waitlist.

Waitlist

The liver transplant waitlist is a computer list maintained by UNOS, which coordinates efforts among donor hospitals and transplant centers nationwide to allocate donated organs for transplantation.

Patient blood type and MELD (Model for End-Stage Liver Disease) score is used to determine position on the liver transplant waitlist. During the waiting period, patients are seen in the UT Southwestern Transplant Clinic and will need to have regular lab work to maintain their position on the waitlist. Transplant surgery usually occurs within six to 12 hours of initial contact.

There is no way to know when a donor liver will become available. Once patients are placed on the waitlist, they need to be available by phone at all times. It’s critical that patients contact their transplant team with any changes in phone numbers, address, or insurance coverage.

It’s also important that patients keep the transplant team updated about any changes in overall health after they have been accepted as transplant candidates. Patients also should notify us immediately if they are admitted to another hospital.

Prioritization and Allocation

To ensure that all patients in need of a liver transplant have equitable access to available donor organs, allocation is based on national policies through the UNOS/Organ Procurement and Transplantation Network, which prioritizes and allocates donor livers to the patients who need them most. These policies take into account factors such as blood-clotting time and levels of bilirubin, creatinine, and sodium. They also help us assess the relative disease severity and risk of death in every patient with end-stage liver disease.

Unlike other transplanted organs, livers are matched only for blood type and size. They do not require special tissue-typing to determine which liver donor makes the best match.

Support Group

Because the waiting period can be stressful, we invite patients and families to take part in a support group led by one of our transplant social workers. We offer patients and families a caring environment in which to share experiences, coping strategies, and information related to liver transplantation. The group is open to patients being evaluated for liver transplantation, those waiting for transplant, and those who have received liver transplants.