Q. What is involved in evaluation testing prior to the transplant?
A. During your outpatient clinic evaluation visit, our goal is to have all the pretransplant initial testing, lab work (including tissue typing) and an array of clinical testing, education, surgeon interview, and social work consultation completed in one day.
Every patient being evaluated for liver transplant will have a psychosocial assessment with a social worker. The purpose of this evaluation is to help determine if a transplant candidate has the psychological stability, motivation and personal support to meet the challenges of transplantation.
Following initial testing, the transplant team evaluates the information gathered and determines whether transplantation is appropriate. We will also determine what additional information is needed prior to placing you on the transplant list. These tests are customized based on your history and conditions, thus avoiding unnecessary testing and costs. It is preferred that these tests be completed at Ohio State’s Medical Center, but depending on your geographic location or payer preference, they may be completed closer to your home.
During the pretransplant clinic visit, you will take part in a comprehensive education program that details the surgical procedure, medications, recovery and rehabilitation associated with the transplant process. After your evaluation is complete, we will send follow-up letters to the referring physician and your insurance company. A referral could be made to Cardiology, Pulmonary, Infectious Disease or other services as warranted.
Q. How do you get on the list to receive a liver transplant?
A. Following initial testing, Ohio State’s transplant team evaluates the information gathered and determines whether transplantation is appropriate. We will also determine what additional information is needed prior to placing you on the transplant list.
If approved for transplant listing, the final step involves approval by the OSU Medical Center Committee, and then by Ohio Solid Organ Transplantation Consortium (OSOTC). The OSOTC has a committee comprised of representatives from other transplant programs and other members who approve all patients for liver transplant listing in the state of Ohio. When approved by the OSOTC, you are then listed for liver transplantation on the UNOS (United Network for Organ Sharing) national waiting list. A letter is sent to your insurance company providing recommendations for transplantation and requesting approval.
Q. How does UNOS prioritize people waiting for a liver transplant?
A. The process for prioritizing candidates waiting for liver transplant is based on each person’s Model for End Stage Liver Disease (MELD) score. The MELD system, developed by UNOS, gives each person a numeric score based on results of three lab test results:
- bilirubin (measures how effective the liver excretes bile)
- INR/prothrombin time (measures the liver’s ability to make blood clotting factors)
- creatine (measures kidney function)
While you are waiting for your transplant, your labwork will be done and MELD score calculated weekly to monthly as determined by UNOS requirements.
Q. What happens when a suitable donor is found?
A. When a liver becomes available for you, you will be notified by the pretransplant coordinator and admitted to the transplant unit, ninth floor of Rhodes Hall.
Ideally, surgery is performed as soon as the organ is available. However, using the latest perfusion techniques, OSU Medical Center is able to transplant liver and pancreas organs within 12 to 24 hours and kidneys.
At the time of admission you will have multiple lab tests done to ensure you are ready for transplant. You also will be seen by the social worker and the nursing staff to complete your initial transplant teaching.
Q. How long is the liver transplant hospital stay?
A. After your surgery, you will be transferred to the SICU for at least 24 hours then transferred to the Transplant Unit as soon as possible.
Your hospital stay could be 10 days to two weeks, depending on complications and your condition.
Q. What is TransChart?
A. You may have access to a patient version of the transplant electronic record called TransChart where you may view your medication list, lab values and vital signs. You can remotely enter your vital signs and lab values if you choose. TransChart is a unique and important tool for your recovery; you are encouraged to have this access.
You and your healthcare providers have access to a toll-free number which is staffed 24 hours a day by a transplant coordinator with access to a transplant surgeon. The transplant team currently monitors the condition of more than 2,500 transplant recipients around the country. This unique service benefits you by providing access to the transplant team if you have questions regarding your transplant. Coupled with the electronic database, this service also provides a way to maintain constant contact with you so we can monitor your progress.
Q. What are the chances of having a successful liver transplant?
A. The OSU Comprehensive Transplant Center, central Ohio’s only adult transplant center, consistently ranks in the top 10 in the nation, both in success rates and in the number of transplants performed.
A great resource for statistics related to solid organ transplantation – kidney, liver, pancreas, intestine, heart and lung – is the Scientific Registory of Transplant Recipients (SRTR) national database. SRTR provides data about everything from survival statistics to waiting list candidates.
Visit the Scientific Registory of Transplant Recipients