Liver transplantation can prolong and improve your quality of life, but waiting for a donor organ can be frustrating and stressful. The wait period for a liver transplant varies, but the median time to transplant for patients on Duke’s waitlist is much shorter than the national average. As you wait for surgery, you will meet regularly with doctors and other members of your transplant team to assess any progression of your liver disease and provide you with the resources you need to stay healthy.
If you are interested in making an appointment for an evaluation, please ask your hepatologist to submit a referral.
The Donor Liver Match Process
If you are a candidate for liver transplantation, you will be listed in the national database maintained by the United Network for Organ Sharing (UNOS). UNOS wait times are based on many factors, including blood type, the size of the donor’s liver, body size, geographical distance from the donor, and your MELD (Model for End-Stage Liver Disease) score. The score is based on blood tests that measure:
- Kidney function (creatinine)
- Liver function (bilirubin)
- Blood clotting time (international normalized ratio or INR)
- Sodium level
MELD scores range from 6 to 40; the higher the score, the greater your need for a liver and the higher your place on the waitlist. When a donor liver becomes available, it is offered to the sickest person on the list who matches the donor’s characteristics like body size and blood type, and is geographically closest to the donor. If the liver is not a good match for that person, it is offered to the next person on the list until it is accepted.
Reducing Your Wait Times
The liver is a regenerative organ, meaning that if it is healthy, it can regrow. This capability creates alternatives to traditional liver transplantation, including split liver and living donor transplants. Your doctor or transplant coordinator can talk to you about these options after you are listed for transplant.
Split Liver Transplant
We’re one of the few liver transplant hospitals to divide a healthy liver from one donor between two patients -- typically an adult and a child. These split liver transplants can shorten your wait for a donor liver and allow us to save two lives rather than one.
Living Liver Donation
In a living donation, part of the liver of a healthy adult donor is removed and transplanted into the person with liver disease. This may be an option if you are unable to wait for a liver from a deceased donor. Donors must be in excellent health to donate.
As a candidate for a liver transplant, you have a responsibility to stay as healthy as possible before and after surgery. This means eating properly, exercising regularly, quitting smoking, abstaining from alcohol, taking your medications as prescribed, and keeping appointments with your transplant team. We have a zero-tolerance policy for alcohol, nicotine, and drug use and may randomly screen you for these substances. Establishing healthy habits before surgery will also help you as you recover and in your life after transplantation.
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 2020–2021.
Be Prepared for the Call
While you are waiting for a donor liver, your transplant coordinator must be able to reach you at all times. The social worker will help you and your caregiver create a reliable plan for getting to the hospital on short notice. When you receive the call that a donor liver has been matched to you, you will be told when to arrive at the hospital. If you live more than a six-hour drive from Duke, we will talk about temporary lodging closer to Durham.