A full spectrum of liver care is available around the clock to support patients through every phase of transplant. At Barnes-Jewish Hospital, transplant candidates and their families receive the one-on-one attention necessary to help them prepare physically, emotionally and financially for the major issues involved in transplantation.
The Evaluation Process
Transplant Nurse Coordinator
With a referral from the patient's primary care physician or hepatologist, potential candidates go through a comprehensive evaluation process by all members of the liver failure and liver transplant teams. The transplant team includes surgeons, hepatologists, pulmonologists, anesthesiologists, cardiologists, psychologists, nurse coordinators, dietitians, financial coordinators and social workers.
The evaluation process includes a two-day outpatient evaluation. Part of the evaluation process includes several tests, which can be done in one convenient location at the Center for Advanced Medicine on the campus of Barnes-Jewish Hospital. While we will try to coordinate tests on one day whenever possible, the tests may require more than one visit to Barnes-Jewish Hospital. These tests may include:
- routine blood work
- X-ray of the heart and lungs
- CT or MRI scan
- pulmonary function tests
- consult with hepatology, cardiology, pulmonology, psychology, social work and financial support
Patients also attend an educational class presented by a liver transplant coordinator and are seen by a liver transplant surgeon and hepatologist. They will receive radiographic studies to determine liver volume and hepatic vessel patency. They will meet with a social worker, transplant financial coordinator and dietitian. Additional consults or testing may be required according to individual circumstances.
Based on your thorough evaluation, your doctors will determine if you are a candidate for a liver transplant.
You are assigned a liver transplant nurse coordinator from the moment you begin the transplant process at Barnes-Jewish Hospital, Your nurse coordinator will work closely with you and will be very familiar with your health status throughout the transplant process. In addition, there is always a nurse coordinator available 24 hours a day for emergency situations.
From the moment you begin the transplant process at Barnes-Jewish Hospital, you are assigned a liver transplant nurse coordinator who is available to you 24 hours a day in emergency situations. Your nurse coordinator will work closely with you, help you manage your medications, make sure you have necessary testing an will facilitate communication between you and the transplant team.
Transplant Waiting List
When you become a liver transplant candidate, you will be immediately placed on the transplant waiting list through the United Network for Organ Sharing (UNOS). UNOS is the agency that oversees and assists the matching, transporting and sharing of donor organs throughout the U.S.
This national waiting list prioritizes donor liver allocation on the basis of the patient’s MELD score (a measure of how sick a patient is based on lab results and other criteria), blood type and geographic location.
Waiting times vary for many reasons. Currently, there are nearly 18,000 people in the United States waiting for a liver transplant. The shortage of organ donors causes most patients to wait for a transplant. The length of time a patient spends on a waiting list depends on many factors including:
- medical urgency or MELD score
- blood type
- height and weight of transplant candidate
- the availability of donor organs
One of our goals is to keep patients home while they're waiting for transplant through specialized treatments, when possible. This makes the waiting time less disruptive to the patient's life.
We understand the wait for a transplant can be a frustrating and sometimes discouraging time. Barnes-Jewish’s transplant support groups and transplant mentor program can help by connecting you with others who are experiencing similar circumstances. Our social workers and financial counselors can also help you through any social or economic issues you're facing as you wait for transplant.
For more information on the liver transplant program at Barnes-Jewish Hospital, call