Liver Transplant Evaluation

Step One: Becoming a Candidate

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Overview

You will undergo an extensive evaluation to help determine if liver transplantation is the best treatment for your liver disease. You and your caregiver will meet with members of the transplant team for a complete medical, psychosocial, and financial evaluation. You will also undergo testing that is tailored to your health condition. The process may take several days, depending on which tests and screenings you need. Your transplant team will help you plan your visit.

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Reasons for a Liver Transplant

Content

Chronic liver failure, also called end-stage liver disease, occurs when your liver is so damaged that it can no longer perform important tasks, such as removing toxins from your body. The causes of end-stage liver disease vary but may include:

Alcoholic cirrhosis
Alpha-1 antitrypsin deficiency
Autoimmune hepatitis
Biliary atresia
Hepatitis B
Hepatitis C
Primary biliary cirrhosis
Sclerosing cholangitis

Our Locations

Liver transplant surgery is performed at Duke University Hospital. Pre- and post-transplant appointments take place at our hepatology clinic in Durham.

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Am I a Candidate for Liver Transplant?

Content

Our liver transplant team will consider several factors during your evaluation. Our goals are to determine:

The extent of your liver disease
The health of your other body systems
Your willingness to follow program guidelines, such as abstaining from alcohol and other drugs
If a liver transplant is the best treatment for you

Ready for an Evaluation?

If you are interested in making an appointment for an evaluation, please ask your hepatologist to submit a referral.

Download Our Referral Form

Tests

Imaging Tests

Description

Imaging tests can help your transplant team learn about your health and determine if liver transplantation is the best option. Depending on your diagnosis and medical history, you may have some or all of these tests:

X-ray or CT to study the chest
MRI of the liver
CT scan of the abdomen to look at the veins and arteries
EKG, stress test, and echocardiogram to study the heart
Lung function testing

Infection Screening

Description

Your transplant team will look carefully at your immune system. This is because after transplant surgery, you will take medicines that prevent rejection of your new liver but will also weaken your immune system. It is important that you do not have any active infection when you are having transplant surgery. Your transplant team will screen you for many infections during your evaluation. These include but are not limited to:

CMV (cytomegalovirus)
HIV
TB (tuberculosis)
Hepatitis
Syphilis
Dental infections

Additional Tests

Description

Depending on your medical history, you may need to meet with other specialists. For example, you may need to see a cardiologist for a heart evaluation. You may also need blood work or other tests.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2021–2022.

Next Steps

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After the evaluation is complete, the liver transplant committee meets to discuss your results and determines whether a liver transplant should be your next step. The committee can make one of these decisions:

A liver transplant is a good option for you, and you should move forward with the transplant process.
More information is needed before they can make a decision. You may need to see more specialists or have more tests before they can decide if liver transplant is best for you.
A liver transplant is not the best option for you at this time.

If you are a suitable candidate, your financial coordinator will work with your health insurance to seek approval for the liver transplant surgery. Once surgery is approved, you will have blood work done to determine your MELD (Model for End-Stage Liver Disease) score. This ranks your degree of sickness and how quickly you need a liver transplant. If you do not already have a living donor, your name will be placed on the United Network of Organ Sharing (UNOS) national waiting list for liver transplantation.

Step 2: Waiting for a Liver

Patient Resources

Reviewed: 12/13/2020