Liver transplant eligibility and evaluation

Our comprehensive liver transplant evaluation allows us to get to know you and understand your health. The team behind Penn Medicine liver transplant performs over 150 liver transplants each year, so we are incredibly experienced in determining whether transplant is your best option.

We are also the region’s leading expert in living donor liver transplants and facilitate the evaluation and eligibility of both organ recipients and their donor matches throughout that process. 

People who are eligible for liver transplant typically have:

• Acute liver failure
• Chronic liver failure
• Liver cancer that hasn’t spread to other areas

If you have end-stage liver disease with one of these conditions, your liver transplant evaluation will determine whether you’re a candidate for the liver transplant waiting list.

This is a chance for our whole team to meet you—and for you to meet us. We comprehensively assess whether you’re physically and emotionally ready for a transplant. You and your family spend one day with us, either in Philadelphia, or at one of our 4 satellite locations that host evaluation clinics. We review your medical records to date and give you a list of additional testing you’ll need to complete the evaluation process. You may complete this testing with us, or closer to home.

The steps of the evaluation process are:

Meetings with providers

You’ll meet with multiple members of the transplant care team, including a transplant hepatologist (doctor who specializes in liver disease), liver transplant surgeon, and the transplant nurse coordinator. They’ll assess your current health, order further testing, and support you through the evaluation and transplant process.

Meetings with support specialists

A liver transplant affects all aspects of your life, so the evaluation process takes more than your physical health into account. In addition to medical providers, you’ll also meet with:

• Financial coordinator: reviews your insurance and finances and makes sure you understand the financial responsibilities of transplant
• Nutritionist: discusses the role nutrition plays in liver health
• Pharmacist: explains the medications you’ll take after transplant
• Social worker: assesses your background, social support system, substance use, and mental health history to make sure you’re set up for success through your recovery

Liver transplant evaluation tests

After the transplant team meets you and reviews your medical records, they’ll order further testing to help us decide if a liver transplant is right for you. Tests you may need include:

• Imaging such as abdominal MRI, abdominal CT, chest x-ray, and chest CT
• Cancer screening tests, including mammogram, pap smear, and colonoscopy
• Blood work
• Labs to rule out underlying causes of liver disease
• Screening and immunity tests for several different viral diseases that affect the liver
• Alcohol and drug screens
• Cardiac tests, such as an echocardiogram and stress tests

Results

When your testing is done and you’ve met with the entire team, we meet to review your evaluation and consider your options:

• Approval: You can take a place on the liver transplant waiting list.
• Denial: You aren’t eligible for a liver transplant.
• Not eligible at this time: Your liver may be too healthy for a transplant right now, so we’ll continue to monitor your condition. You may become eligible in the future for a liver transplant. 

If transplant isn’t an option for you now, we will provide recommendations to your referring provider.