The
pre-transplant evaluation is the next step after the referral
appointment in determining whether transplantation is an
appropriate treatment option. This is also an opportunity for the
transplant team to assess medical factors related to an
individual's liver failure.
As part of this evaluation, individuals will see a number of
specialists and also have a number of tests performed. The results
of these tests will help reveal an individual's overall health and
assist the transplant team in determining whether transplantation
is the best option.
Some tests typically performed during the evaluation are:
-
Blood testsseveral blood tests will be done to
diagnose and assess an individuals overall health condition.
-
Abdominal ultrasoundshows the blood flow to and
from the liver and locates any abnormal masses in the liver.
Ultrasound uses sound waves to create pictures. During this test,
a wand will be moved over the abdomen so that the image of the
liver can be reflected and reviewed on a screen.
-
Chest X-rayexamines the lungs and lower
respiratory tract to help detect any infection and to assess the
status of an individual's bones.
-
Electrocardiogram and echocardiogramexamine the
electrical rhythm and the current function of the heart muscle
and valves. This is done to help identify any changes in an
individual's heart rhythms.
-
Pulmonary function testmeasures an individual's
lung function. Individuals will be asked to perform breathing
exercises and blood will be drawn to determine how well oxygen is
absorbed from the lungs.
-
Upper GI endoscopy (EGD)detects possible varices
(enlarged veins) or ulcers. A flexible tube is passed
through the mouth and into the stomach to look at the upper
intestinal tract. Individuals will be given medication to
help them relax and be comfortable during this test. Afterward,
individuals will need someone available to drive them home.
-
Colonoscopylooks for abnormalities in the lower
intestinal tract. Individuals will be given medication to help
them relax and keep comfortable while a flexible tube is passed
through their rectum into the lower intestinal tract. Afterward,
individuals will need someone available to drive them home.
-
Liver biopsy shows what type of disease is
present in the liver. A special needle is inserted through the
abdominal wall into the liver, which is done to obtain a small
piece of tissue to be examined.
-
Bone density scan determines if individuals
have any bone disease or osteoporosis and obtains a baseline
measurement of the bones before the transplant procedure.
Activation
After the pre-transplant evaluation, the hepatologist will
present the findings in a "Transplant Selection Conference." At
this meeting, the transplant surgeons, hepatologist, nurse
coordinators and all other consultants will review and discuss all
of the patient's test results. They will weigh the potential risks
and benefits to see if a liver transplant is in the patient's best
interest.
If they determine that it is, the liver transplant coordinator
will contact the patient to notify them. Following this assessment,
a letter will be sent to the patient's insurance company seeking
approval for the transplant. Once approval is given, the patient
will be officially activated. At this time the individual will be
placed on a national waiting list to receive a transplant.
Contact Information: For more information on how to schedule an
evaluation or for more information about the Liver Transplant
Program at The University of Kansas Hospital, call (913) 588-1227
or toll-free (800) 332-6048.