Before Liver Transplant Surgery
UC San Diego Health System screens and evaluates your health and related circumstances to help determine the best treatment path when considering liver transplantation. Upon referral from your gastroenterologist, hepatologist or other physician, an extensive course of testing may occur, such as:
- Blood and urine tests to help assess liver and kidney function, blood count, blood type, blood chemistries
- Ultrasound scan to examine blood flow to and from the liver and locate any masses in the liver
- Chest X-ray to determine the health of lungs
- CT Scan or MRI to create an 3D of abdominal structures and look for cancer
- Electrocardiogram to help identify irregularities in heart rhythm and the electrical activity of your heart.
- Echocardiogram to help evaluate how the heart is pumping, how blood flows in the heart and blood vessels, how large the heart is and how the valves are working
- Pulmonary function test to measure lung capacity
- Psychosocial evaluation by a social worker to determine what social support you have, who will help you before and after transplant, how well you cope with stress, and determine if you may benefit from attending AA or NA support groups.
- Psychological evaluation to determine your mental state of well being by performing certain neurocognitive tests.
- Nutrition Evaluation to assess your current nutritional state, determine any deficits, and help provide suggestions to optimize your needs and assist in losing weight if indicated.
- Financial/Insurance Review to review and coordinate your insurance, transplant benefits including copayments and planning for post transplant medication needs.
More or less tests may be required based on your medical condition. Following the testing, the liver transplant team will explain the benefits and drawbacks of transplantation to you and your family and discuss if you are eligible to be placed on the national registry for a donor liver.
Organ Transplant Waiting List
The
United Network for Organ Sharing (UNOS) oversees the allocation of donor organs using the
Model for End-Stage Liver Disease (MELD). MELD and the pediatric equivalent known as PELD are the scoring systems used to assess the severity of chronic liver disease and predict the chances of you surviving 90 days and one year. You will be carefully monitored using the MELD system, including renal function, bilirubin and a coagulation test called INR. Organs are allocated based on MELD score and blood type. Your surgeons will determine which organ is best suited for you to achieve the best long-term outcome. Please become familiar with the MELD score and know your own blood type. Read more about organ allocation and donation.
Planning Ahead
Before your transplantation, you will need to have your care partner and a plan for your care firmly in place. This includes knowing who will provide transportation to your clinic visits, being prepared for extra prescription costs, understanding the extent of your health insurance coverage, and knowing where you will be living when you are ready to leave the hospital. The liver transplant team will help you get your plan ready. Classes, support groups and other resources will help prepare you for the transplant process.
Staying Well Before Surgery
You will be making frequent clinic visits prior to your surgery. It is critical to stay as healthy as you can before surgery so that that liver transplantation can be successful. Your liver transplant team and experts at the
Liver Center will work with you and support you in your daily effort to be in the best health possible before your transplant surgery. As an academic medical institution, UC San Diego Health System can offer programs, new technologies and research opportunities that may help you maintain your best health before a donor liver is available.
Getting the Call
Your transplant coordinator will notify you when a donor liver becomes available. You could receive the phone call at any time of the day or night. We will help you put a plan in place for being able to respond rapidly and arrive at the hospital prepared. Once further tests and evaluations are finalized, the transplant team will complete standard pre-operative preparations and proceed with the liver transplant.
Read more on care
after surgery for liver transplantation.