Liver Transplant Surgery Frequently Asked Questions

The UPMC Liver Transplant program will accept a referral from your doctor or a self-referral.

For more information on what is needed to be referred, please visit the liver transplant referral checklist. Patient information can be faxed to 412-647-5070.

We will also need your health insurance information. This allows us to check your benefits and talk about the costs of a liver transplant with you from the beginning.

The costs of liver transplant surgery vary depending on your insurance, but they can be very high.

Your UPMC liver transplant credit analyst and social worker will:

• Work with you to understand your insurance coverage.
• Give you a packet with information about your insurance benefits and potential out-of-pocket costs for your liver transplant.
• Help you with finding resources to help pay for your liver transplant if you can't cover the costs.
• Patients without insurance will be provided contact information for patient business services and a transplant credit analyst to discuss estimated costs.

In any given year, the number of people seeking a liver transplant is far higher than the number of available deceased-donor livers. This can lead to wait times of over a year.

If you're facing end-stage liver disease, a living-donor transplant may be the best option to improve your quality of life now.

Facts about living donor transplant at UPMC:

• Less time spent on the transplant waitlist
• Less chance of becoming very sick or dying while waiting
• Improved long-term outcomes
• Surgery can be scheduled at a time convenient for both recipient and donor
• Highly experienced transplant team
• Low risk to the donor
• Ability to do the transplant even if the donor is not of a compatible blood type

A living liver donor must:

• Be between the ages of 18 and 55.
• Be in good health.

The donor does not have to be a family member. He or she can be a friend, coworker, or even a stranger. People interested in becoming a liver donor are carefully evaluated to make sure they can safely donate.

To be scheduled for a liver transplant evaluation, a candidate must be alcohol and substance free for a minimum of six months. This includes:

• Alcohol
• Nicotine
• Marijuana
• Cocaine/heroin
• Other illicit substances

Patients with a history of cancer should be treated and cured of their cancer prior to a transplant.

General guidelines:

• Colon/Rectal – 2-5 years
• Breast – 2-5 years
• Renal Cell Carcinoma – 0-5years
• Thyroid – 0-5 years
• Lung – 5 years
• Melanoma – 2-5 years
• Lymphoma – 5 years
• Prostate – 2-5 years
• Leukemia – 5 years
• Multiple Myeloma – 5 years

Patients with these types of cancer will be evaluated individually.

Our experts review the case of every patient who is referred to us. We will consider you for liver transplantation even if you have been previously turned down at a different center.

We can often use some of the results from testing done at other medical centers, but require that you are seen by our physicians and the rest of our transplant team.

The outpatient liver transplant evaluation takes three to five days of appointments and testing to complete.

Patients will have consultations with members of the transplant team, including:

• Transplant hepatologist
• Transplant surgeon
• Social worker
• Transplant nurse coordinators
• Psychologists
• Social workers
• Financial coordinators
• Nutritionists
• Radiology testing
• Cardiac testing
• Comprehensive blood work
• Liver transplant education class
• Other tests and specialists as needed

UPMC does offer “bloodless” transplants for certain people and strict medical requirements must be met.

If you are interested in this option, medical records are reviewed to determine whether you meet the requirements for evaluation. During the transplant evaluation, a consultation is arranged with the Bloodless Medicine team.

Depending on where you live and the status of your liver disease, you may need to travel to Pittsburgh during the liver transplant process.

• While on the liver transplant wait list, you need to live within 4 to 6 hours of UPMC to make sure that you can get to the hospital as soon as a liver becomes available.
• After your liver transplant, you need to stay close for at least a few months for follow-up care.

Family House offers affordable long-term housing for liver transplant patients and their families. Family House is not a medical facility.

The frequency of your follow-up visits depends heavily on the speed of your recovery.

In most cases, you will visit UPMC's post-transplant clinic:

• Once a week for the first month.
• Every two weeks starting at month two.
• Once a month after 6 months.
• From 9 to 12 months, your doctor will determine the frequency.

It's very important that you come to these follow-up appointments. The liver transplant team needs to make sure that your body is not rejecting the new liver and that you're not getting an infection.

Being a caregiver is a big commitment.

He or she will provide support throughout the entire liver transplant process and attend all appointments with you during your evaluation.

After liver transplant surgery, your caregiver must stay with you 24 hours a day, depending on your recovery.

Your liver transplant caregiver will also:

• Make sure you take medicines in the right doses at the right times.
• Help you record all information that the liver transplant team requested.
• Drive you to and from your liver transplant follow-up appointments. You will not be able to drive for 6 to 8 weeks post-transplant surgery.
• Look for signs of unusual behavior and contact your UPMC liver transplant coordinator if anything seems wrong.
• Shop for food and prepare meals.
• Run errands, fill prescriptions, and do chores around the house.
• Provide support, encouragement, and entertainment.
• Keep family and friends informed of your needs and wishes.
• Help you stick to your post liver transplant treatment plan.
• Assist with daily activities within the home.

You can have one person or a whole team dedicated to helping you through the liver transplant process.

Being a caregiver is a big responsibility. You may need more than one person to help you for the first few months after your liver transplant.

Liver transplant caregivers can be a:

• Spouse
• Sibling
• Child
• Friend
• Neighbor

Our team at UPMC will take care of you for at least the first year after transplant, and ideally for life. In some special circumstances, you may be able to find a local transplant center that can help take care of you.

Visit the Scientific Registry for Transplant Recipients website for more information on the program's survival and success rate. The average one-year survival rate is approximately 90 percent.

To explore the possibility of liver transplantation for your child, please contact the Pediatric Transplant Program at Children’s Hospital of Pittsburgh of UPMC at 412-692-6110.

The best way to find willing donors is to share your story. Begin with family and friends, co-workers and church members. People in your social groups. A member of our transplant team can help you with tips and information you can share with people about living donor transplant for children.