Patients are usually referred to us by their hepatologist or oncologist. We do accept self-referrals! Patients are encouraged to seek transplant evaluation as soon as diagnosed with moderate hepatic insufficiency. This is to establish records, perform the appropriate workup, and proceed with transplant listing.
The Work up Process
After successfully completing your initial pre-transplant evaluation, your transplant coordinator will begin scheduling appointments for testing and procedures needed prior to transplant. Some of these tests or procedures will need to be updated annually. Your transplant coordinator will notify you when a test or procedure needs to be updated. It is important to keep up with your tests and procedures so that you can be transplanted when you get the call.
Simple blood tests including blood typing
Coronary Angiogram (For all patients over 45, diabetic, or risk factors/history of heart disease)
Cardiology consult (If you have risk factors, are diabetic or over age 45)
Colonoscopy (For all patients over the age of 50)
Mammogram and Pap smear for all women over the age of 40
Recent Prostate Specific Antigen (PSA) for all men over the age of 40
Patient Selection Committee
All patients will be presented at the Patient Selection Committee Meeting (PSC) after they have completed all their testing and have been seen by the multidisciplinary transplant team.
The purpose of the PSC is to review the results of testing, discuss visits with the multidisciplinary team, and to determine if they qualify for placement on the transplant wait list.
The results of the PSC discussion will be conveyed to the patient and referring physician within 10 days.
If you are approved and cleared by the multidisciplinary team in PSC, you will be added to the National Waiting List for liver transplant. You will be placed on the waiting list based on your blood type and antibody test.
The national organ waiting list is managed by an organization called the United Network for Organ Sharing (UNOS), a private, nonprofit agency that works with the federal government. UNOS keeps track of all the people in the United States who need liver transplants, and matches them with donors.
If you are not approved for listing at the time of PSC, your transplant coordinator will explain any additional testing or requirements to get you listed for transplant. On some occasions, you may not qualify for transplant. Your coordinator will explain in detail as well as send a letter to your primary doctor explaining the reasons you cannot be transplanted at this time.
Day of Transplant
When a suitable donor is found, the surgeon and coordinator will first review donor history and testing results. If the offer is suitable for you, the surgeon will give the OK to admit you for your transplant. In some cases, the surgeon or transplant coordinator may call and discuss the organ offer with you.
Getting the Call
Once you have received a call from the coordinator and you have accepted the organ offer, you will then be instructed to arrive at St Vincent as soon as possible. Please drive to St Vincent with as many important members of your family as necessary.
Your coordinator will ask you the following questions:
What time did you last eat or drink anything?
Have you had any recent admissions to the hospital or new health problems?
Have there been any changes to your life situation (ie, support, financial, or emotional states that may impact your post-transplant care