Liver Transplant Guide

Important Phone Numbers and Locations

Methodist Dallas Medical Center | 214-947-8181 | 1441 N. Beckley Ave., Dallas, TX 75208

The Liver Institute | 214-947-4400 | 1441 N. Beckley Ave., Pavilion III, Suite 268, Dallas, TX 75208

The Liver Transplant Guide is designed to be a resource for patients and their families to walk through the transplant process from evaluation to recovery. The Liver Transplant Guide does not substitute for your transplant team's medical care.

If you have any questions about Liver Transplantation, call us at 214-947-4400.

Evaluation Process

You will be evaluated with consultations, lab tests, and various procedures to determine the appropriateness of transplant. You will meet with many members of the transplant team who may include:

The Transplant Coordinator provides education regarding the transplant evaluation process, listing for transplant, and patient responsibilities before and after transplant. This meeting is intended to provide you with an opportunity to ask questions and to become fully informed about the transplant process.
A Transplant Hepatologist is a physician who specializes in liver disease. The Transplant Hepatologist assesses medical suitability for transplantation, discusses the significance of transplantation (including alternatives and potential medical complications), manages transplant-related medical needs before and after transplant, participates in care during the transplant hospital admission, and follows transplant recipients during clinic appointments at specific time periods post-discharge.
A Transplant Surgeon will meet with you during the evaluation and/or prior to surgery to discuss the appropriateness of a transplant based on the information obtained during your evaluation. The Transplant Surgeon evaluates surgical suitability for transplant, discusses the significance of transplantation with the patient (including the risks, benefits, and surgical complications), discusses the various types of organs available, performs the operation, and provides post-operative care for a defined period of time following surgery.
An Anesthesiologist may meet with you and review your medical records to determine the need for any additional workup to determine your risk from anesthesia.
A Social Worker will meet with you to evaluate your ability to cope with the stress of transplantation and your ability to follow a rigorous treatment plan, both before and after transplantation. The social worker will also help to identify your support network. They will discuss psychological risks, the costs associated with your transplant, and the costs associated with the medications you will require after transplant. They will also work with you to help you understand your insurance coverage. It is important that you understand the costs that may not be covered by insurance.
A Psychiatrist/Psychologist may conduct a more in-depth evaluation and assessment. Some patients with a history of drug or alcohol abuse may be required to participate in a rehabilitation program and meet abstinence requirements prior to and after transplant listing.
A Registered Dietitian will perform a nutritional assessment and provide nutrition education.
Some patients may be referred to another service for consultation. For example, many patients need to be seen by a pulmonologist (lung doctor) or a cardiologist (heart doctor) to assess for other medical conditions.
Many different tests are done to determine if you are a suitable transplant recipient. Some of the following tests may be included in your evaluation process. Remember, other tests may need to be done based on the results of these tests.

Blood tests help to determine the extent and/or cause of your liver disease. Other tests will determine your blood type for organ matching and screen for your immunity to or the presence of specific viruses, including HIV. Additional blood tests may be used to determine how well other organs are functioning.

A chest x-ray helps your physician identify any problems with your lungs.
An EKG, echo-cardiogram and/or stress test will show how well your heart is beating and the function of your heart valves. This will help your physicians decide if your heart function is strong enough for transplant surgery.
An ultrasound of your liver and abdomen helps assess the size, shape, and circulation of your liver.
Pulmonary function tests may be required, especially if you have a history of smoking or a history of lung disease. This is a breathing test to analyze your lung capacity.

Liver Transplant Waiting List

Liver Transplant Operation

Donated organs are allocated according to the policy of United Network for Organ Sharing (UNOS). The surgeon assesses the risks associated with this particular organ versus the risk of waiting for the next available donor and can base the specific recommendations on this information. When a donor organ becomes available, you will be called and you must come to the hospital right away. You always have the option to decline an organ.

During the transplant surgery you will be put under general anesthesia, which means you will be given medications to put you to sleep, block pain, and paralyze parts of your body. You will also be placed on a machine to help you breathe. The anesthesiologist will talk with you in more detail about the risks of anesthesia. The transplant surgeon will make an incision in your abdomen. Through this incision a donated liver will be placed into your abdomen.

Drains may be put into your body to allow fluids to be removed and to help you heal. Special mechanical boots or sleeves around your legs will be used to keep blood flowing through your legs to try to prevent dangerous blood clots. You will be in the operating room approximately 4-6 hours.

Liver Transplant Recovery

After the surgery you will be taken to the intensive care unit where you will be closely monitored. You will be on a machine to help you breathe and you will have many tubes and drains in place. Intermittent pressure boots or sleeves around your legs will be used to prevent blood clots.

Immediately following the surgery, you will experience pain. This will be carefully monitored and controlled. Most transplant recipients have a significant reduction in the pain two to three weeks after surgery.

When your medical condition has stabilized you will be transferred to the transplant floor. Your length of stay in the hospital will depend on the rate of your recovery. You will remain in the hospital as long as your physicians feel hospitalization is necessary. Most patients stay in the hospital for approximately one week, but hospitalization time can vary depending on the severity of your illness prior to transplant or complications after surgery.

After you leave the hospital you will still be recovering. For the first 4-6 weeks you will have some restrictions on your daily activities. If you experience any post-operative complications your recovery time may be longer. During the recovery period the transplant team will follow your progress. You will need to be monitored on a long-term basis and you must make yourself available for examinations, laboratory tests and scans of your abdomen to see how well your transplanted organ is working. Biopsies may be done as needed to diagnose possible complications including rejection or recurrent disease.

The transplant team will see you regularly for three to six months post transplant. Every effort is made to transition your routine medical care to your primary care physician. You will be followed in the transplant clinic for life. For most patients this involves frequent lab work and a yearly clinic visit. Patients who develop complications may need to be seen more often by the transplant team.

If you have any questions about Liver Transplantation, call us at 214-947-4400.

Additional Liver Transplant Resources:

Alternative Treatments to Liver Transplant
Potential Medical/Psycho-social Risks
Miscellaneous Risks for Liver Transplant
Right to Refuse Transplant
Medicare Outcome and Transplant Center Requirements
National and Transplant Center-Specific Outcomes