The liver is the largest solid organ in the body. Its primary function is to detoxify the system, produce bile and provide proteins, glucose and energy to the body. The liver also helps heal wounds by forming blood clots. When any one of these important functions fail, a patient may need a liver transplant to survive. Patients must first qualify.
The University of Arizona College of Medicine has determined clinical features for liver failure. Some of the most common include: - Jaundice: yellowish skin and eye hue that occurs when the liver can't properly rid the body of chemicals and toxins - Hypoalbuminemia: when the blood doesn't have enough of the protein albumin - Coagulopathy: when the body cannot correctly form blood clots - Disseminated intravascular coagulation: when the body’s blood-clotting ability becomes overactive -Spider angiomas: A mass tumor consisting of blood vessels under the surface of the skin - Hepatic encephalopathy: impaired brain function caused by progressive liver damage - Hepatorenal syndrome: kidney failure caused by chronic alcoholism
The United Network for Organ Sharing classifies an adult’s transplant need using the Model for End-Stage Liver Disease (MELD) scoring system if she is 18 years or older, or the Pediatric End-Stage Liver Disease (PELD) scoring system if younger than 18 years. Scores determine who needs an organ most urgently. Scoring methods are based on how likely death could occur without a transplant within 3 months.
Though some transplant centers use slightly varied criteria for eligibility, all patients must have very advanced liver disease to qualify for an organ. The majority of hospitals also require that an individual is able to pay for surgery and treatment. Drug and alcohol abstinence is mandatory, and every recipient must commit to taking her prescribed medications and participate in rehabilitation.
Getting on the Waiting List
Only an organ transplant team can place someone on the national waiting list. Placement will be secured after the following steps are taken. - Find a transplant hospital - Guarantee insurance payment or other finance options - Medical evaluation for necessity - Physician referral
A patient will not be considered for transplantation for the following reasons: - Alcohol and/or substance use or dependence - Cancer in locations other than the liver - Advanced heart or lung disease - A severe infection that can threaten the success of a transplant - Massive liver failure associated with increased fluid in brain tissue - Some transplant hospitals will disqualify those with HIV