Once patients are approved by the liver transplant team and have financial clearance, they are placed on the United Network for Organ Sharing (UNOS) waiting list. UNOS is the agency authorized by the federal government to maintain the database for all transplant recipients in the United States.
Being placed on a waiting list, means that a patient's name and certain medical information is entered into a national database maintained by UNOS. Donor livers are allocated by UNOS and the regional organ procurement organization, Gift of Life Donor Program. Suitable donors have a compatible blood type and size may be a factor as well. Each donor is evaluated carefully by the Gift of Life and the Penn transplant surgeons.
Since the list is based on medical urgency, patient's position on the list may fluctuate based on their health status and as other patients are listed and transplanted.
There are many things patients can and should do while waiting for a liver transplant, including:
- Continue to exercise regularly to promote endurance and speed up recovery after transplant.
- Follow dietary guidelines.
- Carry a cell phone when not at home. The Penn transplant team needs to be able to contact patients on the waiting list at any time.
- Find ways to manage the stress of waiting and coping with chronic illness in order to maintain a positive outlook.
- Notify the transplant program about any other surgery or hospitalization.
- Set up a support group of family and friends to help post-surgery.
- Pack bags and make arrangements for transportation to the hospital in advance.
- Become familiar with post-transplant care.
Liver Donor Becomes Available
When a suitable liver donor becomes available, the on-call nurse coordinator calls the patient, who is told to refrain from eating or drinking and to come directly to the hospital admissions office at the Hospital of the University of Pennsylvania.
Upon arrival, the patient is admitted to the hospital room and the transplant team begins preparing for surgery. They complete paperwork, review medications, check vital signs and draw blood. Patients wait in their hospital room with their support team until it is time to go to the operating room.