6. Evaluation Decision


The transplant evaluation committee is a team of specialists that will meet weekly to discuss your latest evaluation results. They’ll decide whether you’re qualified to receive a transplant or not. The possible outcomes are explained below:

Proceed With Listing

In this case, all your evaluation results have returned indicating that you’re a suitable candidate for liver transplantation. We’ll add you to the liver wait-list, and if you have a potential living donor, it will then be appropriate for potential live donors to contact our department so we may begin their evaluation.

Defer Listing for Additional Testing

This is done based on an individual’s medical condition. For example, candidates may need a colonoscopy, or female candidates may require a mammogram and pap-smear. Some abnormalities discovered through diagnostic testing may require a specialist, such as a cardiologist, pulmonologist, etc. Other patients may require a liver biopsy, or additional radiological testing.

Defer Listing due to Substance Abuse

Almost all transplant centers in the United States require six months of complete sobriety before patients can be considered for transplantation. This is done because the liver is a regenerative organ; without drugs and alcohol its condition may improve to the point where a liver transplant is no longer necessary.

If you have a history of substance abuse we may require you to attend substance abuse counseling before being listed for a liver transplant. Our social worker will discuss this situation with you as necessary.

Decline Listing

Certain issues may disqualify you from receiving a liver transplant. If you are declined, our physician will talk to you about your options. Some of the reasons for being declined may be:

  • Continued abuse of alcohol or drugs, despite the team's request to discontinue its use.
  • Cancer in other parts of the body. If your liver cancer has metastazised, it means it has spread to other organs, so a liver transplant may not be of help.
  • Other types of diseases, such as heart disease, lung disease, or uncontrolled infections.
  • A standing record of noncompliance with our team's instructions. This includes repeatedly missing appointments, not getting labwork done on time, or failing to take your medications.
  • Not having a suitable support system, such as friends or family, to help you with your recovery post-surgery.
  • Being HIV-positive.
  • Having undergone several abdominal surgeries.
  • Advanced age.
  • High levels of obesity.
  • Abnormal anatomical conditions.