Understanding Liver Transplants

Why you need a liver transplant

Your healthcare provider can tell you more about why now is the right time to prepare for a transplant. It may be because your liver is not working as it should. Or you may have a health condition that would be improved by a liver transplant.

Your transplant evaluation

Before you're put on the transplant list, a transplant evaluation is done. This takes place at the transplant center. It takes anywhere from a few days to a few weeks. It's done on an outpatient basis. This means you go home at night. During the evaluation, your health is assessed. Blood tests and imaging tests are done. Your heart and lung health is checked. You should be screened for colon cancer if you're over 50. You and your family will also learn more about transplantation. The transplant coordinator and the rest of the transplant team will talk to you about:

• Benefits and risks of a liver transplant

• Medicines needed after the transplant

• The possibility of organ rejection

• Health insurance and financial issues

• Options for organ donation

• The process of waiting for an organ

• What to expect during surgery

• Care and possible complications after surgery

You'll also discuss:

• The emotional aspects of waiting for a transplant for you and your family

• The emotional aspects of transplant recovery and lifelong medical care

• Travel plans for the time of transplant surgery

• The possibility of not finding an organ in time for a transplant

• Researching other centers with shorter waiting times

• The possibility of a living donor transplant

Where your new liver will come from

Nonliving donation

In most cases, the new liver will come from an organ donor who has just died. This is called a nonliving donation. Before the transplant is done, a donated liver is screened for liver diseases, such as viral hepatitis. It’s also checked to make sure it’s a match with your blood type.

Living donation

Sometimes a healthy living person will donate part of their liver. This is called a living donation. This is often a family member who matches your blood type. Or it may be someone who isn't related to you but whose blood type is a good match.

The liver is the only organ in the body that can replace lost or injured tissue (regenerate). So the part of the liver removed from the living donor grows back after the transplant. And the transplanted liver that you receive also grows to full size after the transplant.

A living donation transplant can be scheduled ahead of time. It may be able to be done sooner than if you go on the waiting list for a nonliving donor. Living donor transplants are less common than nonliving donor transplants. But they are now often done all over the U.S.

Waiting for a transplant

More people in the U.S. are on the waiting list for a liver transplant than there are available donor livers. Getting a liver transplant can be a long process. It could be months or even years before a donor liver is found for you. Here’s what will happen during this time:

• Your name is added to a waiting list. Very sick people are higher on the list than people who don’t need a transplant right away. If you have liver cancer or a rare disease, you may get a liver faster.

• Follow instructions for how to stay in contact with the transplant center. The transplant center keeps your status on the waiting list. If your liver disease gets worse or another health problem occurs, tell the transplant center right away. These events could change your position on the list.

To learn more

• Transplant Living (United Network for Organ Sharing) at www.transplantliving.org  

• Organ Procurement and Transplantation Network at https://optn.transplant.hrsa.gov/

• American Liver Foundation at www.liverfoundation.org