If you are a potential liver transplant patient, you may be referred to Lahey by your primary care physician, gastroenterologist, or hepatologist.
Our pre-transplant nurse coordinators provide dedicated care and support to potential candidates. During the initial consult, a liver transplant physician will review your condition and assess the need for liver transplantation. If you are determined to be a candidate for liver transplantation, a Lahey representative will contact your insurance company to obtain prior authorization.
The Liver Transplant Evaluation Process
If the initial consult indicates that a candidate may benefit from transplantation, the formal evaluation process will begin. This will include consultations with members of the multidisciplinary transplant team. The process begins with an educational session that will inform you about the various liver transplant options available, including live and deceased donor transplantation. The class will provide an overview of the entire liver transplant experience including pre-transplant evaluation, waiting on the liver transplant list, the actual surgery and recovery process, and expectations for long-term follow-up.
Some of the tests you may need during the evaluation include:
- Imaging tests, such as a chest X-ray, liver ultrasound, CT or MRI scan
- Complete blood count, blood clotting, liver function, cholesterol, thyroid, and electrolyte panels. Some of the components of this testing will be used to calculate your MELD score.
- Cardiopulmonary tests, such as an electrocardiogram (EKG), echocardiography, and pulmonary function tests.
- Other tests such as an upper endoscopy, colonoscopy, or a physical examination
Compliance and Support
A transplanted liver, whether from a live donor or a deceased donor, is a precious commodity. To help ensure a good outcome, all liver transplant recipients must comply with the guidelines of the transplant program. These are intended to maximize your health and the function of your new liver. As a condition of participation in Lahey’s liver transplant program, you must sign a document agreeing to abstain from non-prescribed drugs and alcohol and to comply with all recommendations of the multidisciplinary transplant team.
The presence and involvement of family members or friends offers both physical and emotional support to the candidate and has been shown to be associated with long term success for liver transplant recipients. We require that transplant candidates have a plan in place that demonstrates who will support them through this process. A licensed transplant social worker will conduct a complete review of your support system and history of compliance.
Approval and Listing Process
Once the individual evaluation assessments and tests are complete, your information will be presented to the multidisciplinary Liver Transplant Screening Committee. The decision to accept a candidate is made by consensus of the committee after review and discussion of test results and assessments.
The possible outcomes include:
- Listing for liver transplantation
- Recommendation for further testing or monitoring of your compliance
- Determination that you are not an appropriate liver transplant candidate
You will receive a letter detailing the decision of the committee within 10 business days. It will include any recommendations and required follow-up.