Waiting lists

How is an individual placed on the waiting list for a new liver?

Extensive testing must be done before an individual can be placed on the transplant list. Testing includes the following methods:

  • Psychological and social evaluation.
  • Diagnostic tests. 
  • Blood tests – done to gather information that will help determine how urgent it is that an individual is placed on the transplant list, as well as ensure the individual receives a donor organ that is a good match. These tests may include: 
    • Liver enzymes – elevated levels of liver enzymes can alert physicians to liver damage or injury, since the enzymes leak from the liver into the bloodstream under these circumstances. 
    • Bilirubin – produced by the liver and is excreted in the bile. Elevated levels of bilirubin often indicate an obstruction of bile flow or a defect in the processing of bile by the liver. 
    • Albumin, total protein and globulin – below-normal levels of proteins made by the liver are associated with many chronic liver disorders. 
    • Clotting studies, such as prothrombin time and partial thromboplastin time – tests that measure the time it takes for blood to clot are often used prior to liver transplantation. Blood clotting requires vitamin K and proteins made by the liver. Liver cell damage and bile obstruction both can interfere with proper blood clotting.

Other blood tests will help improve the chances that the donor organ will not be rejected. They may include the following factors:

  • Your blood type – each person has a specific blood type: type A+, A -, B+, B -, AB+, AB -, O+ or O -. When receiving a transfusion, the blood received must be a compatible type with an individual’s type of blood or an allergic reaction will occur. The same allergic reaction will occur if the blood contained within a donor organ enters an individual’s body during a transplant.
  • Viral studies – these tests determine if you have viruses that may increase the likelihood of infecting the donor organ, such as cytomegalovirus.

Diagnostic tests may include any of the tests that have been done to evaluate the extent of the disease, including the following:

  • Abdominal ultrasound (also called sonography) – a diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues and organs. Ultrasounds are used to view internal organs as they function and to assess blood flow through various vessels.
  • Liver biopsy – a procedure in which tissue samples from the liver are removed (with a needle or during surgery) from the body for examination under a microscope.

How long will it take to get a new liver?

There is no definite answer to this question. Sometimes, individuals wait only a few days or weeks before receiving a donor organ. If no living-related donor is available, it may take months or years on the waiting list before a suitable donor organ is available. Unfortunately, some people die before an acceptable donor organ can be found.

According to UNOS, in 1998 and 1999, between 17 percent and 23 percent of all patients (adults and children) on the waiting list received a cadaveric transplant. Between 6 percent and 7 percent of all the people on the waiting list died before a transplant could be found. About 5 percent were taken off the list for various reasons.

How are we notified when a liver is available?

Each transplant team has their own specific guidelines regarding waiting on the transplant list and being notified when a donor organ is available. In most instances, you will notified by phone or pager that an organ is available. You will be told to come to the hospital immediately so you can be prepared for the transplant.