Liver Transplant

Liver Transplant Surgery

Appointment New Patient Appointment or 214-645-1919

Appointment New Patient Appointment or 214-645-1919

Using state-of-the-art techniques and technologies, our integrated, multidisciplinary team of experts provides an unparalleled level of patient-focused care with excellent outcomes for patients in need of liver transplantation.

What Should Patients Expect Before Liver Transplant Surgery?

To determine eligibility for liver transplant surgery, doctors evaluate each patient’s overall health, liver condition, and other factors. Our expert team partners with patients and their families to choose the most appropriate treatment.

Liver Transplant 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 function
  • 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

Eligibility for Liver Transplantation

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 they wish to pursue this option – the patient’s name is added to the national United Network for Organ Sharing (UNOS) waitlist.

About the UNOS 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 are 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.

Liver Transplantation 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.

What Should Patients Expect During Liver Transplant Surgery?

During the transplant operation, the anesthesiology team puts the patient under general anesthesia. The diseased liver is removed through an incision in the abdomen. The team then places the healthy donor liver into the patient’s body, making the appropriate connections for the bile duct, artery, and veins.

The transplant surgery usually takes four hours.

Go Inside the Operating Room (OR) for a Look at Liver Transplant Surgery

Join Dr. Parsia Vagefi, UTSW’s Chief of Surgical Transplantation, for unprecedented access to the OR during a liver transplant surgery.

Viewer discretion is advised.

What Should Patients Expect After Liver Transplant Surgery?

After surgery, the patient is taken to the surgical intensive care unit and closely monitored for one day. Once stabilized, the patient will be moved to the transplant floor.

The hospital stay typically lasts four to five days, representing one of the shortest lengths of stay for liver transplantation in the country. During this time, patients learn about medications, future outpatient visits, and general health care issues. Patients also undergo physical therapy and learn how to take care of their new liver.

The recovery period continues after leaving the hospital, and the transplant team will follow the patient’s progress closely throughout recovery. Patients traveling to Dallas from a significant distance should plan to stay near the hospital for up to a month (or more) after discharge. Our team can help provide information regarding discounted housing options for patients and their families.

A family member or friend should stay with the patient because they might not be strong enough to stay alone and might need help with certain activities.

Patients will have some routine restrictions on daily activities for the first six to eight weeks. They’ll need to be monitored on a long-term basis and must agree to be available for exams, lab tests, and scans of the abdomen to see how the transplanted liver is doing. The transplant team will also see patients more frequently for three to six months post-transplant, and the patient will be followed in the transplant clinic for life.

Long-Term Care After a Liver Transplant

It is important to recognize that a transplant is more than a single surgical event. A successful transplant is a group effort that requires a lifetime commitment by the patient to adhere to a healthy lifestyle and receive ongoing medical care.

For the rest of their lives, patients will need to:

  • Take anti-rejection medications
  • Have frequent medical checkups
  • Exercise regularly
  • Eat a healthy diet
  • Forego smoking, alcohol, and street drugs

Read our patient stories.

What Support Services for Liver Transplantation Does UT Southwestern Offer?

UT Southwestern’s Transplant Support Group meets virtually on the third Wednesday of each month from noon to 1 p.m. for transplant patients and their families to share experiences. The group is open to patients being evaluated for liver transplantation, those waiting for transplant, and those who have received liver transplants.

This group (led by a social worker) provides an emotionally supportive atmosphere in which attendees can assist each other in coping with the various issues that arise before and after transplantation. It also provides information on topics of special interest to transplant patients and their families. For example, the dietitian may conduct a group discussion on nutritional information.

For more information about UTSW’s Transplant Support Group, contact Stacy Franz at 214-645-5505.