Liver Transplant Evaluation Process 


Liver transplants are considered only when there is a high risk of liver disease. Two main groups of patients are considered candidates for liver transplantation. The first group involves patients with cirrhosis who develop liver failure. Cirrhosis due to hepatitis C is currently the number one cause for liver transplantation in the western world.  The second group includes patients who suddenly develop acute liver failure from one of a number of causes such as an overdose of acetaminophen, acute viral hepatitis, acute autoimmune hepatitis or an idiosyncratic drug reaction.  

Preparing for Surgery 

Once the suitability for transplant is determined, the initial visit to the transplant center consists of meeting with the transplant surgeon, hepatologist, nurse coordinators, social workers and financial consultants.

Patients undergo an extensive medical evaluation which involves the following exams and tests: 

  • Chest x-ray Electrocardiogram (EKG or ECG). Shows how well the heart is functioning as well as any heart damage.
  • Echocardiogram. An ultrasound of the heart for assessment of cardiac valve areas and functions.
  • Stress test.  Evaluates the flow of blood to the heart to determine the presence of heart disease.
  • Ultrasound with Doppler examination.  Determines the openness of the bile ducts and major vessels.
  • CT (CAT) scan – Computerized image that shows the size and shape of the patient’s liver and major blood vessels.
  • MRI (magnetic resonance imaging) – May be used in place of CT scan or ultrasound.
  • Total body bone scan – If the patient has a malignant liver tumor, the scan determines whether or not it has not spread to the bones.
  • Blood tests.  Includes testing for blood count, blood and tissue type, blood chemistries, immune system function and certain infectious diseases.
  • Blood typing.  Every person is a blood type A, B, AB or O.  The donor’s blood type does not have to be identical to the recipient’s, but it must be compatible.
  • Pulmonary (Lung) Function Test

Many of the required medical tests may be performed locally, if desired, in collaboration with the patient’s primary care physician. We encourage the required medical tests to be completed at Hahnemann.  Our goal is to complete the entire evaluation process and have the patient listed for transplantation within one month. 

When a Liver Becomes Available 

In most cases, blood type determines the compatibility for liver transplants. Surgeons must closely match the blood type and size of the donor liver to the recipient. 

Preparing for Surgery 

Before surgery, all blood work is drawn for the recipient. An intravenous line will be inserted in the arm or just under the collarbone to give medication and prevent dehydration.  The patient will also receive a sedative to help him or her relax before going to the operating room.  


Hahnemann University Hospital | 230 N Broad St, Philadelphia, PA 19102