Q&A: Liver transplant eligibility
Dr. Thomas Collins, transplant surgeon at Centura Transplant, discusses how a patient becomes eligible for a liver transplant. There are several criteria a patient must meet to be a candidate for a liver transplant.
Conditions We Treat
Our Centura Transplant team has decades of experience to treat the following:
- Acute liver failure: Acetaminophen (Tylenol) overdose, Acute viral liver failure
- Alcoholic liver disease
- Viral liver disease: Hepatitis A, Hepatitis B (HBV), Hepatitis C (HCV)
- Fatty liver disease: Non-alcoholic steatohepatitis (NASH)
- Autoimmune hepatitis
- Biliary liver disease: Primary biliary cirrhosis (PBC), Secondary biliary cirrhosis, Primary sclerosing cholangitis (PSC)
- Polycystic liver disease
- Metabolic liver disease
- Cancer: Hepatocellular cancer (HCC), Cholangiocarcinoma (CCA), Neuroendocrine tumors
Liver Transplant FAQs. The answers to questions important to you.
What procedures do you have in place to ensure the safety of patients during the COVID-19 pandemic?
All patients, visitors and hospital staff are required to check in at the hospital entrance each day where they have their temperature taken and are screened for any symptoms connected to COVID-19. Patients or staff members who have symptoms are routed to appropriate care to prevent exposure in the clinic. In our clinic rooms, providers and patients are both required to wear masks and are distanced at least six feet apart during counseling. When a closer exam is required, members of our team are required to wear both masks and eye shields.
What other procedures do you have in place to protect liver transplant patients, in particular?
We offer telemedicine appointments to patients who are not comfortable coming into your clinic. Special precautions are taken for patients on immunosuppression while admitted to the hospital to minimize risk of exposure to COVID-19.
Who would be considered a candidate for a liver transplant?
Candidates for liver transplant have a medical condition that liver transplant will directly treat. Patients are evaluated to ensure that no conditions exist that will make the liver transplant surgery too dangerous, such as severe heart disease. Candidates for liver transplant are also evaluated to make sure there are no conditions that would significantly shorten life expectancy after transplant. The final part of the evaluation ensures that people have the ability and resources to care for the organ for life.
How do you determine if someone is a proper candidate?
Evaluation for a liver transplant is a process. It often starts with multiple provider visits and a detailed history and physical as it relates to your liver disease. This initial appointment will determine what testing and labs are appropriate and the need for additional visits with other healthcare providers, such as psychology/psychiatry, substance use counseling, cardiology, gastroenterology, pulmonology and infectious disease. Once your testing and provider visits are complete, the case is presented to the multidisciplinary transplant committee and a decision regarding candidacy is made.
What are some of the criteria you consider when determining a match?
Allocation of livers is done by blood type and severity of disease measured by the MELD score. MELD score is determined by lab tests. When a donor organ is matched with one of our recipients both donor and recipient characteristics are taken into consideration by the transplant provider. Examples of criteria include donor/recipient age, function of the donor organ, size of the organ and severity of the recipient’s illness.
What is the standard waiting time needed to determine a proper match?
The waiting time for liver transplant is highly variable. It can range from weeks to years, depending on your blood type and severity of illness. In general, the higher the MELD score, the more likely you are to be transplanted. Waiting time is a discussion that incorporates individual factors. This discussion happens with you at the time of evaluation.
What risks are there to liver transplantation?
In general, people do well with liver transplant. However, there are risks that include:
- technical complications that may occur during the surgery
- the new liver may not work, this is rare
- infection due to the severity of liver disease and immunosuppression
- a chance of recurrence of the primary disease
- bleeding during and immediately after surgery
- your body may reject the liver
How successful is liver transplantation?
In general, the success of the liver transplant is very good. One-year survival is greater than 90% and three-year survival is greater than 80% nationally. Individual success after liver transplant is dependent on the recipient’s health, the donor organ and the care that is provided to the organ after transplant.
How long is the typical recovery time following liver transplants?
Liver transplant recovery generally involves one week in the hospital and two weeks of getting stronger at home. Lifting is restricted for a total of six weeks following surgery, then three more weeks avoiding lifting objects at home. Most patients no longer need pain medicine within two or three weeks after surgery. Patients are discharged from the hospital when thy can walk, eat meals and perform all the basic functions of daily living.
What are my limitations? May I return to work or engage in physical activity?
Most transplant patients return to the same or better levels of physical activity within months after surgery. Walking is encouraged the day after surgery. Physical activity is slowly increased beginning six weeks after surgery. Returning to work generally occurs after pain medications are no longer needed and physical restrictions are lifted. Typically, people are able to return to work within four to six weeks after transplant surgery.
Request Information & Referrals
If you are a provider needing to refer a patient to Centura Transplant, please fill out our Centura Transplant Physician Referral Form.
If you are a patient needing more information or a self-referral to Centura Transplant, please fill out our Centura Transplant Patient Self-Referral and Request More Information Form.
Meet Your Liver Transplant Team
Thomas Collins, MD
Organ Transplant, General Surgery
Mary Ann Huang, MD
Gastroenterology, Transplant Hepatology
James Lim, MD
Organ Transplant, General Surgery
Monica Tincopa, MD
Transplant Hepatology, Internal Medicine