Eugenia Tsai, MDGastroenterology
Gregory Abrahamian, MDTransplant
Shreyas Saligram, MDGastroenterology
Plan for liver transplant surgery while you are on the waiting list with expert guidance and care from University Health.
How the Liver Transplant Waiting List Works
Placement on the national computerized waiting list regulates how deceased donor livers are distributed throughout the U.S. United Network for Organ Sharing (UNOS) manages the list. University Health Transplant Institute is part of the UNOS network and receives livers as they become available, usually from organ procurement organizations within Texas.
Your Place on the Waiting List
Your Model for End-Stage Liver Disease (MELD) score is critical to determining your place on the liver transplant waiting list. The MELD score indicates how urgently you need a liver transplant within the next three months. Your MELD score will fall between 6 (lower need) and 40 (higher need). It’s calculated using three lab test results:
- Bilirubin – Measures how effectively your liver excretes bile
- INR (prothrombin time) – Gauges your liver’s ability to make proteins and platelets that help clot your blood
- Creatinine – Assesses your kidney function (impaired kidney function is often associated with severe liver disease)
Count on your transplant team to report your MELD score in the UNOS system and update it.
Other Factors Affecting Liver Wait Time
Talk to your doctor about other things that might affect your wait time for a liver, including:
- How long you’ve been on the waitlist
- Availability of suitable livers
- Blood type
- Body size (height and weight)
- Distance from the hospital where the donor is
Average Liver Wait Time
Waiting can be stressful for you and your caregivers because of the uncertainty. You could wait for several months or years. It’s impossible to predict how long you will have to wait. You may feel sick and still have a low MELD score.
Learn more about the liver transplant waitlist and liver matches on the UNOS website.
While You Wait
Use your waiting period to prepare for transplant surgery. Steps you can take include:
- Attend a pre-transplant class at University Health (a schedule will be given to you)
- Carry a pager or cell phone and give us as many contact numbers as possible
- Continue to attend drug, alcohol and tobacco counseling, if necessary
- Decide who will accompany you to the hospital for your transplant and how you will get there
- Keep in touch with your transplant team
- Notify us of any changes in telephone, address or insurance
- Let us know if you’re going out of town and how to reach you
- Keep your follow-up appointments with the transplant clinic
- Pack a bag for the hospital or have the list ready of what to pack
- Stay as healthy as you can
- Got to yearly tests and consults
- Get routine medical checkups with the transplant doctors
- Have regular blood work done
- Do not use alcohol or illegal drugs
- See your referring doctors
Accommodations and Expenses
Plan for transplant-surgery-related expenses, such as:
Contact your case manager or insurance company to see if you have coverage for some of these expenses.
Check the Visit San Antonio website for help finding a place to stay near University Hospital before and after your transplant.
Self-Care While Waiting
Work toward a good quality of life while waiting for a liver transplant. Continue to see your doctor or specialist as needed.
Alcohol and Drug Use
If you’re on the liver transplant waiting list and test positive for alcohol or illegal drugs, you’ll be placed on inactive status or removed from the liver transplant waiting list for six months. Refer to your Patients Guide to Liver Transplant booklet for more information.
Get the nutrition you need to be as healthy as possible when you have your liver transplant. Rely on your transplant dietitian to assess your food habits, suggest strategies for symptom management and provide general nutritional advice. You’ll benefit from fewer complications, spend less time on the ventilator and have a shorter recovery time after surgery.
Make physical activity a priority. Good nutrition combined with exercise helps you maintain quality of life during the waiting period. Try your best to fit exercise into your daily routine. Light activities at home or walking are good ways to stay active.
Find activities you enjoy: Read, listen to music, volunteer and spend time with friends and family. Relieve stress by discussing issues with your family, transplant team, clergy, social worker or counselor. Join a support group to connect with other patients.
Call 911 if you have a life-threatening emergency while waiting for a transplant. Do not try to drive to University Health. Ask the emergency room doctors to consult with your University Health transplant team.
You will take various medications before your transplant to control your liver disease symptoms. Refer to your Patients Guide to Liver Transplant booklet for more information about pre-transplant medications.