Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Center for Liver Disease & Transplantation

FAQs

What is a liver transplant?
Who needs a liver transplant?
Where do transplanted livers come from?
How are transplanted livers allocated?
How is an individual placed on the waiting list for a new liver?
How long will it take to get a new liver?
How are patients notified when a liver is available?
What is rejection?
What is done to prevent rejection?
What are the signs of rejection?
What is the long-term outlook after a liver transplant?

What is a liver transplant?
A liver transplant is an operation in which a diseased liver is replaced with a healthy one from another person. An entire liver or just a section may be transplanted. The liver may come from a deceased organ donor or from a family member who is willing to donate a part of his or her liver and is a suitable candidate to donate.

Who needs a liver transplant?
A liver transplant is recommended for individuals who have serious liver dysfunction and will not be able to live without having the liver replaced. The most common liver disease for which transplants are performed is cirrhosis. Other diseases may include acute liver failure, biliary atresia, metabolic disease, liver cancer, or autoimmune hepatitis.

Where do transplanted livers come from?
Most transplanted livers come from organ donors who have died, and the surgeon performs what is called a deceased-donor transplant. If the donor is an adult, he or she may have agreed to be an organ donor; parents or spouses can also agree to donate a relative's organs. Donors can come from any part of the United States.

A patient receiving a transplant may get either a whole liver or a segment. If an adult liver is available and is an appropriate match for two people on the waiting list, the donor liver can be divided into two segments so that each part can be transplanted in what’s called a split liver transplant. This is more often done in children than in adults.

A living family member may also be able to donate a section of his or her liver in what is called a living donor transplant. Individuals receiving a partial liver seem to do as well as those who receive a whole liver. Relatives who donate a portion of their liver can live healthy lives with the segment that remains.

How are transplanted livers allocated?
The United Network for Organ Sharing (UNOS) is responsible for all transplant organ distribution in the United States, including livers. UNOS receives data from medical centers around the country regarding patients who need organ transplants and assigns each patient a status code. The people in most urgent need of a transplant are given the highest status and have first priority when a donor liver becomes available.

For more information, see How Transplants Work.

How is an individual placed on the waiting list for a new liver?
Before we place patients on the transplant list, we guide them through the Methodist Liver Transplant Evaluation Process, which includes diagnostic tests, blood tests, a psychological and social evaluation, and other exams.

For more information, see How Transplants Work.

How long will it take to get a new liver?
Your model end-stage liver disease (MELD) score is an important factor in determining your position on the waiting list for a new liver. (See Your MELD Score for more information.) There is no definitive answer to how long it will take. Sometimes, people wait only a few days or weeks before receiving a donor organ. If no living donor is available, it may take months or years before a suitable organ is available.

How are patients notified when a liver is available?
Each transplant team has its own specific guidelines around notifying patients when a donor organ is available. In most instances, you’ll be notified by phone and asked to come to the hospital immediately so you can be prepared for the transplant.

For more information, see How Transplants Work.

What is rejection?

Rejection is a normal reaction of the body to a foreign object. When a new liver is placed in a person's body, the body sees the transplanted organ as a threat and tries to attack it. To allow the organ to successfully live in a new body, medications called immunosuppressants must be given to trick the immune system into accepting the transplant and not thinking it is a foreign object.

What is done to prevent rejection?
Liver recipients must take medications to fight rejection for the rest of their lives. Each person is a unique case, and each transplant team has preferences for different medications. The anti-rejection medications most commonly used include cyclosporine (Neoral), tacrolimus (Prograf), mycophenolate mofetil (Cellcept), and prednisone; see Your Prescriptions for more information.

What are the signs of rejection?
While each patient is different, some of the most common symptoms of rejection include:

  • Fever greater than 100° F
  • Jaundice (yellowing of the skin and eyes)
  • Dark urine
  • Itching
  • Abdominal swelling or tenderness
  • Fatigue
  • Irritability
  • Headache

It’s important to remember that many patients experience rejection with no symptoms whatsoever, so it’s important to keep all follow-up appointments so that your blood can be tested for antibodies and other indicators.

What is the long-term outlook after a liver transplant?
Living with a transplant is a life-long process. Patients must take medications that trick the immune system so it will not attack the transplanted organ. Other medications will be needed to prevent side effects of the anti-rejection medications such as infection. Frequent contact with the transplant team is essential.

There is no good answer to how long an individual can be expected to live after a liver transplant. Some recent data indicates a 50 percent survival rate at 15 years; however, every person and every transplant is different. Results improve continually as physicians and scientists learn more about how the body deals with transplanted organs and search for ways to improve the success of transplantation.

To find out more about the Methodist Center for Liver Disease and Transplantation, call us at 713-441-8839 or at 866-94-LIVER (866-945-4837) or send us an email.