How you prepare

Choosing a transplant center

If your doctor recommends a liver transplant, you may be referred to a transplant center. You're also free to select a transplant center on your own or choose a center from your insurance company's list of preferred providers.

When you're considering transplant centers, you may want to:

  • Learn about the number and type of transplants the center performs each year
  • Ask about the transplant center's liver transplant survival rates
  • Compare transplant center statistics through the database maintained by the Scientific Registry of Transplant Recipients
  • Understand the costs that will be incurred before, during and after your transplant. Costs will include tests, organ procurement, surgery, hospital stays, and transportation to and from the center for the procedure and follow-up appointments
  • Consider additional services provided by the transplant center, such as coordinating support groups, assisting with travel arrangements, helping with local housing for your recovery period and offering referrals to other resources
  • Assess the center's commitment to keeping up with the latest transplant technology and techniques, which indicates that the program is growing

Evaluation

After you've selected a transplant center, you'll be evaluated to determine whether you meet the center's eligibility requirements for a liver transplant. Each transplant center has its own eligibility criteria. If you aren't accepted at one transplant center, you may undergo evaluation at another center.

The goals of the evaluation process are to determine whether you:

  • Are healthy enough to have surgery and tolerate lifelong post-transplant medications
  • Have any medical conditions that would interfere with transplant success
  • Are willing and able to take medications as directed and follow the suggestions of the transplant team

Specific tests, procedures and consultations you may undergo include:

  • Laboratory tests, including blood and urine tests to assess the health of your organs, including your liver
  • Imaging tests, such as an ultrasound of your liver
  • Heart tests to determine the health of your cardiovascular system
  • A general health exam, including routine cancer screening tests, to evaluate your overall health
  • Nutrition counseling with dietitians who assess your nutritional status and make recommendations regarding nutritional intake before and after transplant
  • Psychological evaluation to assess and treat any underlying issues, such as depression or anxiety, and determine whether you fully understand the risks of a liver transplant
  • Meetings with social workers who assess your support network to determine whether you have friends or family to help care for you after transplant
  • Addiction counseling to help people with alcohol, drug or tobacco addictions to quit
  • Financial counseling to help you understand the cost of a transplant and post-transplant care and to determine what costs are covered by insurance

Once these tests and consultations are completed, the transplant center's selection committee meets to discuss your situation. It determines whether a liver transplant is the best treatment for you and whether you're healthy enough to undergo a transplant.

If the answer to both questions is yes, then you're placed on the liver transplant waiting list.