If we move forward with the evaluation, we will make arrangements to perform a number of tests and consultations, including:
Blood tests to determine your blood type; liver and kidney function; viruses to which you may have been exposed such as hepatitis A, B, and C, and the AIDS virus
Chest x-ray to see if your lungs are healthy
Electrocardiogram (EKG or ECG): an electrical tracing of the heart rhythm - to look for heart abnormalities or evidence of past damage
Echocardiogram, an ultrasound examination, that allows the doctors to look at the function of your heart
Pulmonary function tests, a series of breathing tests to estimate lung function
An abdominal CT or MRI scan: an imaging analysis of the abdominal region - so physicians can measure the size of your liver and assess blood flow through arteries and veins
A bone density scan to assess for brittle bones
- You will need to
see your dentist for evaluation
- We may order a
series of other tests, depending on special circumstances:
- A colonoscopy for all patients over 50 years or those with a family history of colon cancer
- A stress test for patients with diabetes or those at risk for heart disease, which uses exercise or medications to stress your heart so physicians can check for evidence of coronary artery disease
- A mammogram for all female patients older than 40 years
- A prostate-specific antigen (PSA) test for all male patients older than 40 years to screen for prostate cancer.
- A skin test for tuberculosis (TB), for patients exposed, or at risk for exposure, to TB
- A bone scan and a CT scan of the chest for patients with liver cancer
- Cardiac catheterization if coronary artery disease is present
- Vascular studies such as an angiogram to assess blood flow to the legs if necessary
Healthcare Professionals You Will See
As part of your evaluation, you will see a
transplant surgeon. The surgeon will assess your liver condition and the need for liver transplantation. The surgeon will also discuss the surgery, and post-operative recovery period with you, and address possible alternative therapies to surgery.
In addition, the evaluation testing that you complete may dictate that you need to see the following health care providers:
We also suggest that you meet with our
financial coordinator, who along with your social worker, will help you map out a financial plan if you are accepted as a transplant recipient.
Blood and Tissue Typing
During the evaluation, we will determine your ABO, or blood type. We will also test your HLA (Human Leukocyte Antigens) type, which is a test of certain proteins in your blood that are important for transplant matching. Although the HLA typing was very important in the past, with modern transplant medications, the effect of matching on the success of the liver transplant is not as important today. You will also have your blood checked for antibodies against human leukocyte antigens that may be on potential donors. This information will help your doctors determine how difficult it will be to find a suitable donor.
Psychosocial and Behavioral Health Evaluations
Part of the transplant evaluation process is to identify and try to resolve any psychosocial or behavioral health issues that might interfere with the success of your surgery and long-term recovery. Our behavioral health team includes a clinical psychologist and clinical social workers with extensive transplant experience. We also have access to BIDMC psychiatrists with considerable transplant experience. Our services include programs to help with:
- Managing the stress of illness, transplantation, or transplant care giving
- Improving quality of life before and after transplant
- Depression and anxiety
- Managing your medications
- Smoking cessation
- Losing weight
- Alcohol and drug relapse prevention
- Strengthening your support system
behavioral health program helps improve care quality and patient outcomes by supporting transplant patients and their families, before, during and after transplantation.
Transplant evaluation is an outpatient process. While many of the tests will be performed at the Transplant Center, some can be done at a hospital or clinic closer to your home.