When to Get on the Liver Transplant List?

A liver transplant involves the surgical removal of a patient's diseased liver in order to replace it with another liver from a donor. Medically, this is referred to as OLT, or orthotopic liver transplant. The patient may either receive an entire liver or a portion of the donated liver. You must first qualify in order to be a recipient for the transplant, and typically must get on the liver transplant list before getting a transplant.

When You Should Get on the Liver Transplant List

• You should get on the liver transplant list when it becomes evident that your liver will eventually fail. This decision must be made by your doctor on a case-by-case basis. As soon as it is clear to your doctor that your liver will fail, you should put your name on the liver transplant list, as there is typically a long wait to get a liver transplant. This means you should get on the list even if your condition has not yet rendered your liver fully dysfunctional.

  Generally, your doctor will advise you to get on the list as soon as you are diagnosed with one of the following conditions: advanced cirrhosis, an autoimmune disorder that is attacking the liver, biliary atresia, liver cancer, or liver failure.

Steps to Take

• You will not be able to add your name to the list until after you have fulfilled certain conditions, so following these steps before trying to get on the list is essential. Generally, before you can put your name on the list you must undergo tests and evaluations and be diagnosed with an advanced liver disease. Most centers and hospitals will also require that you be capable of paying for the surgery and accompanying treatment so you will want to prove this before getting on the list. It is mandatory that you abstain from drugs and alcohol, and you must be committed to taking all prescribed medications and undergoing the appropriate rehabilitation process. Thus, if you are addicted to drugs or alcohol or are not following protocol for your medical condition, you must resolve those issues before getting on the list.

  You may be rejected for transplantation based on the following conditions: dependence on alcohol and drugs; cancer in other organs; advanced heart and lung diseases; other severe infections that can inhibit the success of a liver transplant; or massive liver failure accompanied by the increase of fluids in the brain. Some hospitals may also render those infected with HIV ineligible.

Other Considerations

• If you need a liver transplant and are deemed qualified, your name will be added to a nationwide waiting list kept by the United Network for Organ Sharing or UNOS when you and your doctor make the request and prove that all of the qualifications are met. Your body size, blood type and severity of your condition will play a huge role in determining when you can receive a donated liver. The sickest patients are at the top of the waiting list. Typically, a donor will be matched to a potential recipient based on certain factors such as body type, ABO blood type, degree of health urgency and the MELD (model for end-stage liver disease) score. UNOS employs a computerized-point system that ensures fair distribution of the organs. Recipients will be chosen based primarily on the severity of the condition or health urgency within each of the ABO blood group on the list.

  Your placement on the national waiting list will only be secured when you have located a transplant hospital, you have guaranteed payment through insurance or other financial means, you have been evaluated for eligibility, and you have received a physician's referral.