LIVER
Transplant
The Liver Transplant Program at the Texas Transplant Institute on the campus of Methodist Specialty and Transplant Hospital* is recognized nationally for its successful outcomes in all types of transplantation. The expertise of the liver transplant team makes it possible to offer a level of service that is on par with the top programs in the country for transplantation, hepatology, and liver disease care.
Indications for Liver Transplant
A liver transplant is performed in cases of end-stage liver disease (ESLD) or liver failure. Diseases and conditions resulting in end-stage liver disease for which transplantation may be indicated include primary biliary cirrhosis, sclerosing cholangitis, liver cancer, and alcohol/drug abuse. Hepatitis B and C viruses can also develop into liver failure, possibly requiring a transplant. However, a transplant does not cure hepatitis. Early diagnosis and disease management can help patients decrease their risk of hospitalization.
The goal of the Liver Transplant Program is to exhaust all medical therapies before resorting to a liver transplant, which is reserved as a final life-saving option. The Liver Failure Clinic at the Texas Transplant Institute offers comprehensive treatment programs for liver failure management. Our hepatologist has extensive experience with the latest clinical treatments including radio frequency ablation, chemoebolization, as well as access to new clinical research and treatment protocols. In addition, the Liver Failure Clinic offers ongoing educational sessions for patients and their families; licensed nurses, dietitians, social workers, and chemical dependency counselors provide information and answer questions regarding physical, psychological, and social issues.
Types of Transplants
A patient receives a liver transplant from a deceased donor. The potential recipient is placed on the UNOS national donor waiting list. Because the donated liver must match the recipient's blood type and size, the waiting period can be a few weeks to several years. While waiting, the recipient must follow the physician's orders and be evaluated periodically.
Although not yet performed at Texas Transplant Institute, another type of transplant is the living donor partial liver transplant. Because the liver is the only organ to regenerate itself, new technologies have made it possible to remove a portion of a healthy liver for transplantation. This type of procedure is most often done for pediatric patients.
Pre-Transplant Expectations
The first step in the transplantation process begins with a referral to the Texas Transplant Institute by the prospective patient's physician. A transplant financial coordinator verifies transplant insurance benefits and begins creating a financial plan regarding all transplant services. The clinic then contacts the patient and the referring physician's office to discuss expectations and schedule a half-day pre-transplant evaluation. The patient's referring physician is considered part of the transplant team and will be involved in all facets of the transplantation process.During the initial clinic visit, the patient meets the transplant team which includes the transplant hepatologist or transplant surgeon, nurse, dietitian, and social worker for a psychosocial evaluation. After the first visit, the transplant team will review the medical, psychosocial, and diagnostic test results from the evaluation.
Shortly after the first clinic visit, the patient, referring physician, and insurance company are given the recommendations made by the transplant team regarding any additional tests which must be performed to complete the evaluation. Once all testing is complete, the transplant hepatologist, surgeon and other team members meet at a Patient Care Conference to discuss the patient’s transplant evaluation and determine if the patient is suitable for placement on the organ waiting list or requires further evaluation. The patient, referring physician, and insurance company will be notified, regardless of the outcome of the Patient Care Conference. If the patient is to be added to the UNOS waitlist, they will be given specific instructions by the transplant clinic as to the frequency of follow-up while they are waiting for an organ to become available.
The average wait for a liver is 6 to 12 months and organs are allocated according to the Meld/Peld Scoring System. Some patients, depending on their clinical condition, will require hospitalization while waiting for their transplant. Patients who reside outside of San Antonio may require temporary lodging near the transplant center during their wait. Texas Transplant Institute will assist out-of-town patients in finding housing accommodations for the immediate post-transplant period.
Private insurance, as well as Medicare and Medicaid, provides coverage for liver transplants. However, the costs may not be fully reimbursed. Our financial coordinators can assist the patient with information and planning.
Our medical, social, and financial specialists are always available to answer questions and provide assistance regarding transplantation.