Liver Transplant: Evaluation
The transplant decision is a complicated one and involves input from a lot of people, including you.
Our evaluation process has been carefully coordinated to meet the specific needs of your health history.
We make every effort to schedule your entire evaluation to fit into a single two-day visit to the University of Iowa. We need two days because of the number of visits with the various team members and the volume of tests required to determine if you are a transplant candidate. We know that you may have traveled a long distance to get here and we want to be respectful of your time. If this proves inconvenient for you, we can easily break your evaluation up into two separate visits.
Every evaluation is different because every patient is unique. Typically, every evaluation includes an update of your health history, blood draw for routine laboratory tests, thorough history and physical exams, an assessment by a social worker, a review of your insurance by a financial counselor, and additional testing or consults as needed.
Potential liver transplant candidates will complete an evaluation process that includes a variety of blood and urine tests, chest x-ray, EKG, heart function testing (echo cardiogram and a stress test for some patients), and consultations with team members. Defining a clear picture of your current health status is critical in order to determine the likelihood of a successful transplant outcome.
As part of your medical evaluation, you will meet with a team of doctors and auxiliary staff. These may include:
- Transplant Surgeon
- Transplant Hepatologist
- Clinical Psychologist
- Transplant Coordinator
- Social Worker
- Financial Counselor
- Other specialists as dictated by your particular needs
At the evaluation conference you will meet with a transplant coordinator, who is a registered nurse specializing in organ transplantation. During this meeting, the coordinator will describe all aspects of the transplant process.
You are encouraged to bring family and friends to this meeting. You will learn about how candidates are screened, risks and benefits of transplantation, complications of the procedure, hospital routines, and care after you leave the hospital.
During the educational session, you will have ample opportunity to ask questions and discuss your concerns. You will be provided materials to take with you from the education session. The transplant coordinator will assist you and your family throughout your entire transplant process.
The liver transplant team has a multidisciplinary approach, which stresses the importance of treating individuals as a whole. We recognize the importance of the patient's emotional and mental needs, as well as physical concerns.
Transplant social services will meet with you at your evaluation. The social worker gathers information about you and your family, your coping abilities, substance abuse history, support systems, and ability to follow important post transplant instructions. This information helps the social worker determine your needs while you are in the hospital and how to better prepare you for the transplant experience. The social worker provides emotional support, information, plans for your discharge, and can help you explore appropriate groups and service agencies in your local community.
Prior to even starting your evaluation, our transplant financial counselor will contact you to obtain all pertinent information about your insurance coverage. Transplant can be expensive. Our financial counselor will work with your insurance carrier to obtain the necessary approvals for your evaluation to proceed.
If there are gaps in your coverage, the financial counselor will discuss options with you and your family so you have the most current information in order to help you deal with the financial issues. The financial counselor will help you with potential resources so you can receive the transplant.
Approval for Transplantation
When the evaluation is completed, the liver transplant committee will review the results of the tests, procedures, and consultations obtained during your visit. This committee, which meets weekly, consists of the nurses, physicians, social workers, and others who you have met throughout the evaluation process. All members contribute their opinion; and a decision is made with regard to further testing, additional treatment, or if you should be added to the waiting list.
If you are approved for transplantation, you will be placed on the waiting list of the United Network for Organ Sharing (UNOS). You will be notified in writing and by phone of the decision and what, if any, additional steps are necessary.
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