The transplant process begins with a referral. Your physician can refer you to Ochsner’s liver transplant program by phone, fax, or mail. You may also call in to refer yourself. We will then contact you to gather initial information over the phone. After we get clearance from your insurance company, your initial consultation appointments are scheduled.
The evaluation process involves an initial medical workup, which will include a consultation and lab tests to determine the medical appropriateness of liver transplant. For your initial appointments, you will have a consultation with the Transplant Hepatologist, a physician who specializes in liver disease. You will also meet with a Financial Coordinator who will discuss the costs associated with your transplant and with the medications you will require after transplant. They will work with you to help you understand your insurance coverage. It is important that you understand the costs that may not be covered by insurance. Once your initial appointments have been completed, you will be scheduled for more in-depth medical tests.
During the work-up phase, you will meet with the Transplant Coordinator who will provide education regarding the transplant evaluation process, the listing process, and patient responsibilities before and after transplant. A Transplant Surgeon will also meet with you and discuss the appropriateness of a transplant based on the information obtained during your evaluation. The surgeon will also discuss the significance of undertaking a liver transplant, the various types of livers available, and the risks of the surgery and the possible complications after your transplant. You will also meet with a Social Worker to evaluate your ability to cope with the stress of transplantation and your ability to follow a rigorous treatment plan, both before and after transplantation. The social worker will also help to identify your support network.
Many different tests are done to determine if you are a suitable transplant recipient. Some of the following tests may be included in your evaluation process. Remember, other tests may need to be done based on the results of these tests.
- Blood, urine & stool tests
- X-Rays, CT Scans & ultrasounds
- Lung function tests
- Cardiac Evaluation
- Upper & lower GI exams
- Consults with other specialists
Once all medical tests have been completed, your case is presented in front of a committee to discuss your eligibility for a transplant. If it is decided that you meet the requirements, you will placed on the list for transplant. During your waiting time, you may be required to come in every one to three months for updated testing. The median waitlist time for liver recipients on our waitlist is 26 days, which is one of the shortest wait times in the U.S. Most listed patients can wait at home for a liver transplant.
When a donor organ becomes available, you must be able to leave home right away to be admitted to the hospital for the transplant.
During the transplant surgery you will be put under general anesthesia, which means you will be given medications to put you to sleep, block pain and paralyze parts of your body. You will also be placed on a machine to help you breathe.
The transplant surgeon will make an incision in your abdomen. Through this incision your liver and gallbladder will be removed and a donated liver graft (without a gallbladder) will be placed into your abdomen. You will be in the operating room approximately 4-8 hours. As with any major surgery, there are risks involved. The surgeon will explain the risks of surgery to you.
After the surgery you will be taken to the intensive care unit where you will be closely monitored. When your medical condition has stabilized you will be transferred to the transplant floor. You will remain in the hospital as long as your physicians feel hospitalization is necessary for your recovery. Most patients stay in the hospital for approximately one week.
After you leave the hospital you will still be recovering. For the first 4-6 weeks you will have some restrictions on your daily activities. During the recovery period the transplant team will follow your progress. You will need to be monitored on a long-term basis and you must make yourself available for examinations, laboratory tests and scans of your abdomen to see how well your transplanted liver is working.
The transplant team will see you regularly for the first year after transplant. You will be followed in the transplant clinic for life. For most patients this involves frequent lab work and a yearly clinic visit. But it is also necessary to have a primary care physician who will continue to care for your general health needs. Every effort is made to transition your routine medical care to your primary care physician. The transplant coordinator and physicians are available 24 hours per day to assist your local doctor in caring for you.