- I’ve been told I have hepatitis C. Is it fatal?
- How badly is my liver damaged?
- What is a liver biopsy?
- Will I need a transplant?
- Should I ask to be put on a transplant waiting list?
- How are people placed on a waiting list for a liver transplant?
- How is the severity of my condition determined?
- How long is the waiting time?
- Does it help to get on a list sooner?
- Can a person be on more than one waiting list?
- What might make me unable to receive a liver transplant?
- Where can I find answers to additional questions about liver transplant?
Not necessarily. While Hepatitis C can lead to liver failure, the disease is not an automatic death sentence. Only about 20 percent of patients with Hepatitis C will eventually progress to the point of needing a life-saving transplant. Highly effective therapy to cure hepatitis C is routinely used by our hepatologists to treat eligible patients.
Specific blood tests and a liver biopsy are the best way to tell how much damage has been done to the liver.
A liver biopsy is an outpatient procedure to obtain a small piece of the liver for testing under the microscope. It is the gold standard for determining the extent of your liver disease and your liver’s ability to function. For the procedure, the area is cleansed with a sterile solution. A local anesthetic is used and a small needle is inserted between the ribs into the liver to obtain a sample. Recovery takes about two to three hours, and patients go home the same day with instructions to avoid any heavy lifting for a few days. The risks associated with a liver biopsy are minimal. We safely perform hundreds of liver biopsies each year at Froedtert Hospital.
Whether or not you’ll need a transplant can best be determined based on information obtained from a liver biopsy, blood tests, clinical evaluation and a detailed conversation with your hepatologist about your disease and the risks and benefits of a transplant.
Before you ask to be placed on a transplant list, you should understand your condition as completely as possible as well as the pros and cons of receiving a transplant. In some cases, you might be better off without a transplant. That may change in the future if your disease changes, but understanding your disease and all the options open to you, as well as the risks of each option, will help you make an informed decision. It’s our job to monitor you and know when to start thinking of a transplant.
After undergoing a thorough evaluation, eligible patients are placed on a national transplant waiting list based on the severity of their liver disease, ensuring that the sickest patients receive organs first, regardless of how long they’ve been on the list. Patients with acute liver failure, for example, are placed at the top of the list because of their immediate need for a transplant.
A scoring system called the Model for End-Stage Liver Disease (MELD) is used to assess the severity of chronic liver disease and prioritize patients on the waiting list.
Wait list placement is based on the MELD score, ensuring that the sickest patients receive organs first, regardless of how long they’ve been on the list. Patients with acute liver failure, for example, are placed at the top of the list because of their immediate need for a transplant.
No. Being on the list longer does not mean a patient will receive a liver any sooner.
Yes. Some patients will ask to be put on a waiting list in more than one region because the waiting times may be longer in their home region.
Several conditions might make a patient ineligible for a liver transplant. The most common are advanced heart or lung disease that would make the surgery risky, and liver cancer that is beyond the transplant criteria or has spread outside of the liver. Cessation of alcohol, tobacco and recreational drug use and adequate rehabilitation are also mandatory for patients who had history of using these substances.
More information is available through the following resources:
- United Network for Organ Sharing (UNOS)
- Scientific Registry of Transplant Recipients
- Transplant Living
- American Liver Foundation