How are candidates for liver transplant determined?

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Before people become liver transplant candidates, the liver transplant team performs an extensive evaluation of their liver disease and general health to determine if transplant is the right option.

People whose livers do not function well due to life-threatening problems may be candidates for a liver transplant. A number of studies must be completed during and prior to the evaluation visit. These tests include:

  • Chest x-ray
  • Abdominal doppler ultrasound to evaluate blood vessels going to and from the liver
  • Pap smear and mammogram for women
  • Blood tests
  • Urine test
  • Cardiac evaluation

During the evaluation visit, potential liver transplant candidates and their families meet with members of the transplant team, including a transplant nurse coordinator, and receive detailed information about transplant preparation, health management during the waiting period, anti-rejection medications and an overview of the transplant process. People see a transplant hepatologist, a doctor who specializes in liver diseases, and sometimes a transplant surgeon to discuss their medical history, receive a physical examination, and to describe the different options for liver transplant.

People are also encouraged to consider living-donor transplantation, since it offers the best chance of success and survival.

In addition, people meet with a financial coordinator to ensure they have adequate insurance coverage for the procedure and medications. Other members of the liver transplant team including the social worker and nutritionist may meet with potential liver transplant candidates and their families as well.

The liver transplant team will then meet to determine whether transplant is the best treatment option for each person evaluated. A member of the transplant team then contacts the potential candidate with the results of this discussion. If the transplant team decides that liver transplant is the best option and the potential candidate agrees, this person is "listed for transplant."

Candidates for liver transplantation undergo thorough medical and psychiatric evaluations. Medical tests may include blood tests, heart tests, lung evaluations, and more.

Radiologic testing may include:

  • chest x-ray to determine the health of the lungs;
  • ultrasound to examine the liver, abdominal organs, and blood vessels;
  • CT scan of the liver;
  • MRI of the abdominal organs and blood vessels;
  • endoscopy to assess ulcers or inflammation in the esophagus and stomach;
  • ERCP (Endoscopic Retrograde Cholangiopancreatography) to view the bile ducts;
  • liver angiogram;
  • liver biopsy, or other tests.

A psychosocial team evaluates potential candidates and their families or support teams, and assists patients with psychosocial needs. Social support services are available to patients and their loved ones to help them cope with the many issues that arise during the transplantation process. It is vital that all potential transplant recipients have support systems to provide help throughout the process. The Center strongly recommends that patients take advantage of its educational resources, support groups, and other services, because patients and families both benefit greatly from the information and support they provide.

Substance abuse screenings may be conducted at random during this process; use of alcohol or illicit drugs will render patients ineligible for liver transplantation.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.