X-rays, liver biopsy slides and a record of medications are used for pre-evaluation for a liver transplant. To complement and to update previous tests, some or all of the following diagnostic studies are generally performed during your evaluation.
- Computed tomography, which uses X-rays and a computer to generate pictures of the liver, showing its size and shape
- Doppler ultrasound to determine if the blood vessels to and from your liver are open
- Echocardiogram to help evaluate your heart
- Pulmonary function studies to determine your lungs' ability to exchange oxygen and carbon dioxide
- Blood tests to determine blood type, clotting ability and biochemical status of blood and to gauge liver function. AIDS testing and hepatitis screening are also included
If specific problems are identified, additional tests may be ordered.
There are two types of liver transplant options: living donor transplant and deceased donor transplant.
Living donor liver transplants are an option for some patients with end-stage liver disease. This involves removing a segment of liver from a healthy living donor and implanting it into a recipient. Both the donor and recipient liver segments will grow to normal size in a few weeks.
The donor, who may be a blood relative, spouse, or friend, will have extensive medical and psychological evaluations to ensure the lowest possible risk. Blood type and body size are critical factors in determining who is an appropriate donor.
Recipients for the living donor transplant must be active on the transplant waiting list. Their health must also be stable enough to undergo transplantation with excellent chances of success.
In deceased donor liver transplant, the donor may be a victim of an accident or head injury. The donor's heart is still beating, but the brain has stopped functioning. Such a person is considered legally dead, because his or her brain has permanently and irreversibly stopped working. At this point, the donor is usually in an intensive-care unit.
The identity of a deceased donor and circumstances surrounding the person's death are kept confidential.