Who Is a Liver Transplant Candidate?
If you are experiencing liver failure or if you have localized liver cancer, you may be a candidate for liver transplantation. Liver failure can be acute (have a sudden onset) or chronic (long-lasting).
Acute liver failure is caused by:
- Overdose of acetaminophen
- Viral hepatitis
Chronic liver failure can be caused by:
- Chronic hepatitis
- Cirrhosis (replacement of normal liver tissue with scar tissue)
- Cholangitis (scarred and narrowed bile ducts, which causes bile to back up in the liver)
- Wilson disease (storage of excessive copper in your liver)
- Hemochromatosis (hereditary disease in which your body stores too much iron)
Symptoms of liver failure
The most common symptoms of liver failure are:
- Ascites (fluid build-up in the abdomen)
- Edema (swelling) of hands and legs
- Confusion and forgetfulness
- Constant itching
- Jaundice (yellow skin and eyes)
- Chronic weakness
- Muscle loss
Complications can include bacterial and fungal infection, low blood sugar and, in the most serious cases, swelling of the brain.
Treatments for liver failure
Treatment for acute liver failure depends on the underlying cause. Treatments may include:
- Activated charcoal: This reduces the amount of acetaminophen absorbed into your digestive tract.
- N-Acetyl Cysteine: Taken orally or intravenously, this drug can help in cases of acetaminophen overdose and other causes of acute liver failure.
- Lamivudine: This type of drug stops the hepatitis virus from replicating.
- Steroids: These drugs treat autoimmune hepatitis.
- Liver transplant: If the other treatments do not work, you may be a candidate for a liver transplant.
Qualifying for a liver transplant
You may qualify as a liver transplant candidate if:
- A liver transplant could improve your quality of life.
- You do not have other diseases that cannot be treated or are not too sick to likely survive the transplant surgery.
- All other medical or surgical treatment options either have not worked or are not a good choice for that patient.
- You and your support systems (family and friends) understand and accept the risks of having a liver transplant.
- You and your support systems are fully committed to and compliant with what is needed before and after the transplant, to make the transplant a success. This would include access to funding for the transplant procedure, post-transplant medicines, and other healthcare costs. The social worker and patient financial liaison may be able to help find other ways to pay for your care.
If you are approved for a liver transplant, your name will be put on a waiting list to receive a donated organ. People with the most urgent need are placed at the top of the list. Never will race, ethnicity, religion, national origin, gender or sexual orientation have any part in deciding if you are a transplant candidate.
You may be disqualified from having a liver transplant if you have:
- Current alcohol or drug abuse problems
- Uncontrolled infection that will not go away with a transplant
- Metastatic cancer or bile duct cancer
- Failure of other organs that will not get better with a transplant
- Uncontrolled HIV infection with AIDS despite treatment
- Irreversible brain disease or damage
- Severe, untreatable heart and lung disease
Tests to determine if you are a candidate for liver transplantation may include:
- Blood tests: These laboratory tests will determine your blood type, clotting speed and liver function, while screening for diseases that would disqualify you for transplantation.
- Liver biopsy: In this procedure, tissue samples are removed from the liver for examination under a microscope.
- Computed tomography (CT scan): This test uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. CT scans more detailed than general X-rays.
- Doppler ultrasound: This test uses high-frequency sound waves to create an image of the liver and to assess blood flow through various vessels.
- Echocardiogram: This test studies your heart function and viability as a transplant candidate.
- Pulmonary function study: This test studies your lung function and viability as a transplant candidate.