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Liver Transplant


Liver Transplant FAQs

See below for frequently asked questions about liver transplantation.
What distinguishes the liver transplant program at Barnes-Jewish Hospital?
How many liver transplants are performed at Barnes-Jewish Hospital each year?
How are potential liver transplant patients evaluated?
How does the MELD scoring work?
What are the survival rates?
How long do I wait on the list?
Do I have to take the medicines forever?
Can I travel while I am on the waiting list?
Do I have to come to Barnes-Jewish Hospital to do all my testing?
How far away from Barnes-Jewish Hospital can the patients live?

What distinguishes the liver transplant program at Barnes-Jewish Hospital?
In 1985, Barnes-Jewish Hospital became the 16th hospital in the world with a dedicated liver transplant program and the first in Missouri to perform a successful liver transplant. Since then, the hospital has continued to be a world leader in liver transplantation, and the management of end stage liver and hepatabiliary diseases including hepatacellular cancer and cholangiocarcinoma.

With survival rates among the best in the nation, Washington University School of Medicine transplant specialists have helped more than 1,100 adult liver transplant  recipients survive life-threatening illness, giving them a chance for renewed health. The gastroenterology program, ranked among the top programs in the nation by U.S. News & World Report, offers a depth of clinical and research experience and an array of leading-edge resources.

How many liver transplants are performed at Barnes-Jewish Hospital each year?
Since 2006, the Barnes-Jewish liver transplant program has at least 85 transplants per year, with 99 transplants performed in 2009.
Research indicates that greater patient volumes increase the experience of the clinical team and, as a result, improve patient success rates. Barnes-Jewish Hospital's liver failure program is among the largest in the country. Our liver specialists care for patients waiting for transplantation and those for whom transplantation is not an option. The unequaled commitment and passion of this team have helped advance the treatment of liver failure, ensuring many seriously ill patients make it to transplant.

How are potential liver transplant patients evaluated?
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. Each patient is assigned a liver transplant nurse coordinator who facilitates communication before and after transplant. The evaluation process includes a two-day outpatient evaluation. Patients get bloodwork, a chest X-ray and EKG. They 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.

How does the MELD scoring work?
Patients listed for a liver transplant are tested and assigned a Model for End-Stage Liver Disease (MELD) score, which is based on a system designed by UNOS. The MELD score is a numerical scale, ranging from 6 (less ill) to 40 (gravely ill), used for liver transplant candidates. It gives each person a "score" (number) based on how urgently he or she needs a liver transplant within the next three months. Patients with higher scores are given priority for transplants. The number is calculated by a formula using three routine lab test results:

  1. Bilirubin, which measures how effectively the liver excretes bile;
  2. INR (prothrombin time), which measures the liver's ability to make blood clotting factors; and
  3. Creatinine, which measures kidney function. (Impaired kidney function is often associated with severe liver disease).

What are the survival rates?
Barnes-Jewish Hospital has maintained excellent survival rates for liver transplantation since the program was initiated in 1985. Using a multidisciplinary approach, combining the efforts of medicine, surgery and outstanding support services such as interventional radiology, our liver transplant team is able to take on some of the most complex and challenging patients.

How long do I wait on the list?
Unfortunately, the number of people waiting for a liver transplant is growing faster than the number of organs available. The length of time on the list depends on the severity of the liver disease. Because of the MELD scoring process, sicker liver patients don't have to wait as long.
Approximately 50% of all patients listed at Barnes Jewish Hospital receive a  liver transplant within 6 months of listing.

Do I have to take the medicines forever?
To prevent rejection of the new liver, patients usually stay on the medications as long as the transplant is still functioning.

Can I travel while I am on the waiting list?
Yes, under most circumstances.  Please consult with your transplant coordinator prior to making travel arrangements.

Do I have to come to Barnes-Jewish Hospital to do all my testing?
Liver transplant patients are required to get most of their testing done at Barnes-Jewish Hospital.

How far away from Barnes-Jewish Hospital can the patients live?
Usually, there are not restrictions on where patients waiting for a liver can live, but they must have arrangements made so they can arrive at the hospital within six hours. People from all over the world travel to Barnes-Jewish Hospital to be cared for by Washington University School of Medicine transplant specialists.

For more information on the liver transplant program at Barnes-Jewish Hospital, call 314-TOP-DOCS (314-867-3627) or toll-free 866-867-3627.

Using Transplant to Treat Live

Cholangiocarcinoma is a cancerous growth in one of the ducts that carries bile from the liver to the small intestine. Surgeons at Barnes-Jewish and Washington University are advancing treatment of the disease, transplanting the livers of some patients.

 
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