There are three types of Liver Transplant:

Deceased (Cadaver) Donor Liver Transplant: Patients with advanced liver disease, who do not have the option of a living donor transplant, join the waiting list for a deceased donor.

Living Related Donor: This refers to a living donor who is a healthy blood relative of the person awaiting transplant. This could be a sibling, parent, child, aunt, uncle, cousin, among others.

Living Unrelated Donor: This refers to a healthy person who is emotionally close to but not blood related to the person awaiting transplant. This includes one’s spouse, in-law relatives, and close friends. A living unrelated donor also may include an altruistic donor or someone involved in a liver-paired donation or donor chain.

The patients who present with complications arising from long standing chronic liver disease or cirrhosis are candidates for Liver transplantation. The complications / symptoms seen in patients with cirrhosis are: 

• Jaundice (Rise in Bilirubin or yellowing)
• Ascites (abdominal distention due to accumulation of fluid)
• Hepatic Encephalopathy (Mental Confusion of varying degree)
• Gastro Intestinal bleed (Blood in Vomit or Black foul smelling Stool)
• SBP: Infection of ascitic fluid (presents with fever and abdominal Distention)
• Kidney Failure or HRS (rising creatinine/ decreased urine output)
• Decreased Sodium levels, or
• Hepatocellular carcinoma

After the transplant operation, you will be taken to the transplant intensive care unit, where a team of trained transplant specialists will take care of you. 

Your heart rate, blood pressure, respirations, liver function, kidney function, and intravenous fluids will be measured and recorded.

Blood tests will be performed to test the function of the newly transplanted liver and if there is bleeding or infection. Your wound will be examined and recommendations will be made on the activity you should do that day and on your diet. You will be encouraged to walk as much as you can. While you are in the hospital, you will speak with a dietitian to learn about healthy eating habits to maintain the health of your new liver.

Potential Issues After Transplantation

Short-term

• Bleeding
• Infection (bacterial or viral)
• Bile leak

Long-term

• Infection (bacterial or viral)
• Acute rejection
• Chronic rejection
• Biliary stenosis
• Skin cancer, lymphoma
• High blood pressure
• High cholesterol
• Diabetes
• Obesity
• Osteoporosis

The transplant team must evaluate your medical condition by using the results from a number of tests.  The condition of your heart and lungs is especially important to determining the risk of surgery.

This table displays examples of some of the tests you will need to take to determine your medical condition before transplant. You will be required to meet with our financial coordinator, psychologist, and social worker prior to your transplant. In addition, it is important that you have no active infections or cancer outside the liver.

Important Tests for the Transplant Workup

• Chest X-Ray: Examines heart and lungs
• Electrocardiogram (EKG): Studies the rhythm of the heart
• Dobutamine Stress Echo: Examines the function of the heart under stress transthoracic echocardiogram (TTE) and can predict whether the patient is at risk for a heart attack
• Standard Cardiology: Workup is a TTE
• Transthoracic Echocardiogram (TTE): Accurately assess the overall health of the heart
• Ultrasound of the Abdomen: Checks the blood vessels of the liver
• ABO Typing: Identifies the blood type and needs to be done twice
• Dental Evaluation: It is important that dental health is kept up to date — at least one visit per year. Dental infections can create a serious health risk after transplantation.
• Gynecologic Evaluation (including PAP smear and mammogram): It is important that these studies are kept up to date, so that problems can be immediately discovered and treated to stay healthy and not affect the ability to obtain a transplant.
• CAT Scan of the Abdomen: To determine if your liver contains any tumors or defects
• Ultrasound of the Abdomen: To check blood flow of major vessels to your liver
• Pulmonary Function Test: This test shows how well your lungs work, as a decrease in lung capacity is a risk factor for surgery

Further testing may be required, depending on the type of liver disease you may have.