Steps to a Liver Transplant

Once your doctor or doctors have determined that you need a liver transplant, here are the steps you need to take to make sure everything goes as smoothly.

First, remember that you'll probably be focused on the operation itself, and understandably so. But transplant surgery is just part of the process of getting a new organ. There will be steps to take before and after you are wheeled into the operating room.

Your first call should be to your health insurance provider. You may have already brought your insurance company into the loop during the diagnosis process. If you haven't, now is the time to do it. Be sure the transplant center you want to use is accredited by your insurance company, and make sure you fully understand what they'll cover and what they won't.

Your next stop will probably be a transplant center itself. Find out how many times they've done your procedure, and what the survival rate has been. Transplant center statistics are available through a database maintained by the Scientific Registry of Transplant Recipients.

Don't forget to find out what support services are offered by the transplant center. Many transplantation facilities can provide assistence with travel arrangements, local housing where you can stay during recovery, and support groups and other helpful organizations.

Once you've chosen a transplantation center, they'll want to start evaluating you. They'll try to determine if

• you have any medical conditions that could be helped by a liver transplant,
• your health is good enough to undergo surgery,
• you're able to take the medications you'll need to get through the surgery and recovery,
• you're emotionally ready for the strain of waiting for a donor and the other stresses that accompany any major surgery
• you have the support of family and friends to help you get through the transplant.

If you need a transplant because your liver is failing from alcohol or drug abuse, you'll also be evaluated to determine if you can forgo using those substances in the future.

Finding a liver donor

Once your evaluation has been completed and you've been accepted, the search for a donor will begin.

Everyone who's waiting for a donor is placed on a list maintained by UNOS (the United Network for Organ Sharing). Most donors are people who have recently died after suffering some kind of trauma. Once the donor has been declared brain dead, and a blood type has been determined, a transplant candidate with a matching blood type and similar body size will be selected from a database.

At this stage, the transplant candidate gets a call from the center. Since a liver that's been harvested from a deceased person may only be usable for 24 hours (though transplant surgeons prefer just 8 hours), it's important for the candidate to be ready to move as quickly as possible.

Some presurgical tests will be done, and an IV line will be started. You'll be given some steroids which will help prevent rejection of the new organ by your immune system. You'll also receive antibiotics to prevent infections.

Soon, you'll be in the operating room. The surgery itself takes 6-8 hours.