Liver Transplantation Evaluation Prcocess
We are flexible with regard to evaluation and testing. Many tests can be performed at your facility, at the facility of your choice or at Montefiore Medical Center.
Evaluation Process for Liver Transplantation
- Mandatory education program attended by the patient and a family member or companion serving as the patient's healthcare proxy
- Consultation with a transplant surgeon, hepatologist, transplant coordinator, social worker and financial counselor
- Laboratory tests
- CT or MRI of the abdomen
- Doppler ultrasound of the liver
- Chest X-ray
- Pulmonary function tests
- PPD to determine exposure to tuberculosis
- Routine health screening, which may include mammography, colonoscopy and Pap smear
- Chest CT scan and bone scan (cancer patients)
What to Expect
- Consultation with a transplant psychiatrist, family physician, cardiologist, pulmonologist or infectious disease specialist
- Cardiac stress test
- Cardiac catheterization
- Head CT scan
- Liver biopsy
Because the evaluation process can be lengthy, we work with patients to make the process as convenient as possible.
All components of the evaluation must be completed before a patient may be placed on the waiting list. Each patient's case is discussed at a selection meeting attended by all transplant team members. The patient will be assigned to one of three categories: suitable for transplantation; possibly suitable, but requiring additional testing; or unsuitable for transplantation. In the event the patient is not considered a candidate for transplantation, alternative treatments will be recommended.
Patients found suitable for transplantation are immediately registered on the United Network for Organ Sharing (UNOS) waiting list, regardless of whether the organ will be procured from a living or deceased donor.
General Contraindications to Liver Transplantation
- Recent or active substance abuse, including alcohol or illegally obtained drugs
- Advanced or uncontrolled medical condition that would make recovery difficult or dangerous, such as serious cardiopulmonary disease, psychiatric disorder and infection
- Primary liver cancer beyond stage I or II
- Metastatic cancer spread to the liver
- Recent or active cancer outside the liver
- Inadequate social support/family assistance
- Undocumented immigration status (in certain cases, legal visitors to the United States may be able to receive organ transplants)