Liver Transplant
Evaluation

Most liver transplant patients at UCSF are referred to the program by primary care doctors or by a specialist. When a referral is made, a transplant program coordinator will call you to schedule an appointment, typically on a Tuesday.

Preliminary Evaluation

A preliminary evaluation is the first step in helping you and the transplant team determine whether transplantation is an appropriate treatment for your child. It also enables the transplant team to assess the medical factors related to your child's liver failure. Not everyone who is evaluated for a liver transplant actually needs one. Your initial appointment will help determine your child's treatment options.

The preliminary evaluation will take a full day, from about 8 a.m. to 4 p.m., and can be very tiring. The following tips will help you prepare for this first appointment:

  • If possible, bring family members or close friends to help you understand and remember the significant amount of information you will be receiving about the transplantation process.
  • Because your child will be undergoing many tests, don't let him or her eat or drink anything after midnight of the day before your appointment. Plan to bring a snack.
  • Please bring any medications your child is taking, your health insurance information and your child's medical records if you have them.

As part of the evaluation, a series of tests will be conducted, including:

  • Blood tests to help determine how well your child's liver is functioning and to assess kidney function.
  • Chest X-ray to help detect infection in your child's lungs and assess the status of your child's bones.
  • Electrocardiogram to help identify any changes in your child's heart rhythm.
  • Pulmonary function test to measure your child's lung capacity. Your child will be asked to breathe into a machine, and blood will be drawn to determine how well oxygen is being absorbed from his or her lungs.
  • Ultrasound to view the blood flow to and from your child's liver and to locate any abnormal masses in the liver.

A liver specialist, called a hepatologist, and a surgeon will also evaluate your child. The hepatologist will do a full exam, review your child's health history and discuss what it means to be on the transplant waiting list.

You can discuss your test results with the hepatologist and surgeon and both will answer any questions you have. Many parents find it helpful to write down their questions before the appointment.

You will also meet with a financial counselor to review your insurance information.

Waiting For a Transplant

Once the evaluation is complete, the transplant team meets to discuss each case and to decide whether to add your child to the national waiting list for available livers. Once on the waiting list, you will be notified and your child will undergo further testing at your local doctor's office.

Parents with children on the cadaveric waiting list will receive instructions about getting a pager and informing the team about changing health conditions. Since a donor liver may become available at any time of the day or night, you must carry a pager with you at all times and keep it turned on when you're not at home. The wait for a new liver is generally two to three years.

When a donor becomes available, careful testing is performed to ensure that the organs are not damaged in any way. Then, they are matched to a transplant candidate of compatible size and blood type. In some cases, the team may conclude that the donor liver is not satisfactory. If this occurs, the transplant will be canceled. If a cancellation occurs, remember that it is in your child's best interest.

Before your child's operation, a social worker will talk to you to about his or her adjustment after the surgery. Individual counseling is also available during your hospital stay. If necessary, a social worker can arrange follow-up services and answer questions about disability.

Living Donor Liver Transplantation

Transplant livers may come from a cadaveric donor who has died, or from a living donor. A living donor is usually someone in the family or a close family friend. Living donor liver transplantation allows surgeons to perform the transplant without the sometimes-lengthy wait for a cadaveric liver. Both donor and recipient livers grow and regenerate after the transplant. During the transplant evaluation, we will discuss living donor transplants with you.

Donor safety is of primary concern throughout the process. Donors must be in good health, have a blood type that's compatible with the recipient and be motivated to donate by altruistic reasons. If live donation is suitable for your child, a donor evaluation will be started after all of your child's testing is complete. If the transplant team determines the donation would work, a surgery date is scheduled for both your child and your child's donor. This whole process usually takes up to six months.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Organ Transplant

Liver Transplant Program
1825 Fourth St., Sixth Floor
San Francisco, CA 94158
Phone: (415) 476-5892
Fax: (415) 476-1343
Appointment information

Patient Experiences