Liver Transplant Evaluation and Listing

Learning you need a liver transplant can be scary—but at Virtua Advanced Transplant & Organ Health, rest assured you’re not on this journey alone. Our experienced and compassionate team will guide you through the evaluation needed to place you on the list for a new liver.

Our Approach to Liver Transplant Evaluation and Listing

Our liver transplant program is built upon one of the largest practices in the region for the treatment of liver disease. Our hepatologists (liver specialists), use the latest approaches for the diagnosis and treatment of liver disorders, including hepatitis B and C, alcoholic and nonalcoholic fatty liver disease, cirrhosis, and liver cancer.

If you do need a liver transplant, know that you are in good hands. Virtua Advanced Transplant & Organ Health has been performing liver transplants for more than 20 years, and is one of only two hospitals in New Jersey approved to perform the procedure. Our experienced doctors, nurses, social workers, and other specialists provide the best possible care before, during, and after surgery so you can get back to living your fullest life.

Liver Transplant Evaluation

Your transplant journey begins with a phone call to our liver transplant referral coordinator. During the conversation, we’ll talk through your personal and health history, as well as any conditions that may affect a successful outcome.

If you meet the criteria for a liver transplant, the coordinator will schedule your appointment for a full evaluation.

What to Expect During Your Liver Transplant Evaluation

You will meet with members of our liver transplant team. The team consists of transplant surgeons, hepatologists, anesthesiologists, transplant administrators, and transplant coordinators, as well as a psychiatrist, social worker, pharmacist, finance coordinator, and dietitian.

The evaluation will determine if your medical, social, and psychological condition will likely result in a successful transplant.

You can expect to undergo:

• Blood and urine tests to confirm your blood type and look for any viruses or diseases
• An echocardiogram and stress test to determine your heart health. You also may need an angiogram and cardiac catheterization to examine blood flow through your heart, liver, and blood vessels
• A chest X-ray to check your lung health
• An MRI or CT scan of your abdomen
• An abdominal ultrasound to check the blood vessels going to and from the liver and look for any obstructions or tumors
• An endoscopy to check for bleeding in the gastrointestinal tract
• A colonoscopy, based on your age and family medical history, to check for pre-cancerous polyps
• For women, a gynecologic exam and Pap smear. Women age 40 and older will need a mammogram
• For men older than age 40, a PSA blood test

Appointments can last several hours, so you are encouraged to bring a loved one or other support person.

If you are already listed for transplant at another hospital and are seeking to increase your chances of getting a new liver, you must still be evaluated at Virtua Advanced Transplant & Organ Health.

Listing and Waiting for a Liver Transplant

Once your evaluation is complete and the Virtua team determines you are eligible for a liver transplant, you will be placed on a national waiting list managed by the United Network for Organ Sharing (UNOS). Authorized by the federal government, this organization maintains the database for all transplants in the United States.

How the Liver Waiting List Works

The wait time for a liver transplant has increased dramatically as the demand for livers greatly exceeds the supply. Because of this, UNOS developed a scoring system.

The most important part of the score is the severity of your illness. This is measured by your Model for End-Stage Liver Disease (MELD) score. Scores range from 6 to 40, with the most ill patients having the highest numbers. The MELD score is determined from four lab tests:

• Bilirubin: measures how effectively your liver makes bile
• INR: prothrombin time, which indicates your liver’s ability to produce clotting factors
• Creatinine: measures your kidney function
• Sodium: measures the level of an electrolyte in the blood that is a marker for significant liver disease

The presence of a liver tumor also is included in the score. Depending on your health, your MELD score may change over time.

Other factors that can affect how long you wait for an organ include your blood type, body and organ size, and time spent on the waiting list.

Ethnicity, gender, religion, and financial status aren't part of the matching system.

Listing at More Than One Center

Because the wait time for a liver can be long, UNOS allows people to be listed at more than one center for a transplant. This is called multiple listing, and may increase your opportunities to receive an organ sooner.

You can be listed with both Virtua Advanced Transplant & Organ Health and any other hospital that provides transplant services. Please check with your insurance carrier to determine coverage of multiple listing evaluation services.

What Happens When a Donor Liver Becomes Available

When you're matched with a donor liver, a Virtua transplant nurse coordinator will call you and ask you to come immediately to Virtua Our Lady of Lourdes Hospital. It's important that you and your support people are reachable and prepared to go to the hospital at all times.