Before we list you as a transplant candidate, you’ll need to go through our evaluation process. This is to help us determine that: 1, you are healthy enough to undergo surgery; 2, you are reliable with our appointment schedule and medications; 3, you have a support system to help you with recovery.
Imaging Scans
Will let us see if your lungs and windpipe are healthy enough to withstand the stresses of donation surgery, since anesthesia can be very taxing to your respiratory system. The x-ray will also let us know if you have tuberculosis, or other lung problems.
This noninvasive exam will allow us to see the internal structure of your liver. We’ll be able to look for abnormal blood flow, cysts, infections, scar tissue (fibrosis), fatty liver cells, gallstones, lesions, masses, or bile duct obstructions.
We’ll scan your abdomen, which will produce computerized images that allow us to look at the size, shape, and position of your liver, as well as its blood vessels and bile ducts. This will allow us to identify and categorize any liver abnormalities.
(If indicated in patients with liver cancer) we will perform a full-body scan, similar to an x-ray, that will help us find out if a tumor in the liver has spread to other parts of the body.
Lab Tests
Blood will be drawn repeatedly to help our team determine several medical characteristics. These include your blood type, liver function levels, and other health-related items. We’ll also check for certain infections, such as hepatitis, HIV, etc.
MELD stands for Model for End-Stage Liver Disease. It's a score that combines three blood tests (Bilirubin, INR, and Creatinine) to determine the severity of your liver disease. This score ranges from 6 (normal liver function) to 40 (severe illness), and it is used to prioritize patients on the waitlist. Visit our waitlist page to learn more details of the MELD score.
You will have to take immunosuppresants after receiving a liver transplant. These medications lower your immune system, which makes you susceptible to infections; Therefore, we must make sure that your body is free from infections from the beginning, such as HIV, hepatitis, or tuberculosis before you receive a transplant.
Cancer markers are substances that are typically found in the blood or urine when a patient has cancerous tumors. Some marker substances can be produced by the tumor itself, or by your body's response to the tumor being present. We'll test your blood and urine for these markers to help us determine if your body has a tumor.
The technician will draw blood to determine the ratio of red blood cells, white blood cells, and platelets in your bloodstream. Abnormally high or low counts of one of these three cell types will alert us that there's something wrong with your general health.
This blood test is one of the factors in determining your MELD score. The lower your blood clotting ability, the higher your score, which indicates higher urgency of condition.
Additionally, coagulation is an important factor during transplant surgery because it helps control bleeding. If your coagulation ability is low, you'll be placed on procoagulants before surgery.
Organ transplant recipients are more likely to have a tuberculosis reactivation than the general population. With that in mind, we must conduct blood tests to determine the presence of tuberculosis. If it's latent in the patient, we'll know that we'll need to administer drugs to prevent reocurrence of the disease.
Cardiopulmonary Tests
Our technician will attach pads on your chest to measure your heart’s electrical output. This will let us know if you have an abnormal heart condition we should be aware of.
We’ll ask you to breathe normally into a tube, and then we’ll ask you to inhale and exhale deeply. This will tell us your lung capacity and overall health of your respiratory system.
An ultrasound of the heart. It will look for normal heart function, and any problems with the heart’s valves. We’ll also conduct a stress test to measure your heart during high output; you'll be asked to perform an exercise, and we'll see how your heart reacts.
If your echocardiogram stress-test was non-diagnostic (meaning, the results were inconclusive), we'll need to perform a secondary stress test. This is similar to a CAT scan of the heart, where we'll take one image with your heart at rest, and another during exercise.
Other Tests
A small camera will be lowered down your throat and into your stomach to look for abnormalities in your digestive tract. The same will be done from the rectum to look at your intestinal walls.
A general physical will be necessary to determine your overall health, weight, blood pressure, and health history. Our physician will also assess whether you’ll need additional tests based on your individual condition (such as pap smears, mammograms, etc.)
Certain candidates will be required to visit the dentist for transplant clearance. This exam will check for any mouth infections or necessary dental work. If infections are found, they'll need to be treated prior to being added to the organ waitlist. If dental work is required, it should also be treated prior to surgery, since the chance of infection will increase after the transplant, due to immunosuppressant medications.
