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
Before your transplantation, have a care partner and plan firmly in place. There should be no doubt who will be caring for you. Know who will provide transportation to your clinic visits. Know your insurance coverage. Be prepared for extra prescription costs and copays. If you need help, be sure to talk to our liver transplant financial coordinator. Classes, support groups and other resources
will help prepare you for the transplant process.
Know your plan for housing when you are ready to leave the hospital. You will need to visit us several times a week right after the surgery and for up to 3 months after. It's especially important to know where you will be living if you do not live in San Diego County.
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.