The Liver Transplant Program at the Loma Linda University Medical Center (LLUMC) Transplantation Institute is a fully integrated, multidisciplinary program which provides world-class care to adult and pediatric patients with liver disease. During every phase of their transplant journey at LLUMC, our patients and their family members experience compassion, support and professional, personalized care.
After you’re referred to the Transplantation Institute, you’ll meet with our transplant team for evaluation. The purpose of the evaluation is to determine if liver transplant is a safe and effective treatment. This increases the likelihood of a successful liver transplant.
During your evaluation, you’ll meet with the hepatologist (liver specialist) and transplant surgeon who will review your medical and surgical history. We’ll administer the following lab tests to identify potential problems before they occur and assess your overall health:
- Blood tests (e.g. tissue typing, blood typing, antibody screening, viral testing)
- Abdominal CT or MRI scans
- Pulmonary (lung) function test
- Chest x-ray
- EKG (electrocardiogram)
- Dobutamine stress test
- Additional tests as necessary
You’ll also meet with your transplant coordinator to teach you about transplantation and help you make arrangements for special tests needed to complete your evaluation. Our social worker will conduct a psychosocial assessment to determine if you have the psychological stability, motivation and support to meet the challenges of transplantation. Finally, a financial coordinator will consult you about your finances and medical coverage.
The final requirements for consideration include a dietary evaluation and participation in one-on-one patient teaching and weekly support groups.
Upon completing your evaluation, the Patient Selection Committee will meet to discuss your case. This team of transplant surgeons, a hepatologist, transplant coordinators, nurses, a financial coordinator, an immunologist and social worker will discuss any concerns to determine if you’re eligible for the organ donor waiting list. When the committee recommends you for a liver transplant, your name will be placed or “activated,” on the national organ donor waiting list UNOS (United Network for Organ Sharing).
Be advised our transplant coordinator will contact you, too.
If you are a substance abuser, or have been, the Liver Transplant Team will require documentation of at least six months sobriety or abstinence before you can qualify for the liver transplant waiting list. You’ll be subject to a random screening.
Waiting for an Organ
All patients accepted for transplant are immediately placed on the national database at UNOS. UNOS is the national agency formed to help match and distribute deceased donor organs equally to patients waiting for transplant. When a liver becomes available, a point system based on the severity of illness called the MELD (Model for End Stage Liver Disease) or PELD (Pediatric End-Stage Liver Disease) determines who will receive the donated liver. Based on laboratory blood test values, the MELD and PELD scores assign patients with a score based on how urgently they need a liver transplant. Other factors are also taken into consideration including blood type matching, body size and condition of the organ.
As you await transplant, the Transplantation Institute will regularly touch base with you. In the meantime, we recommend that you stay active as possible, take your medications as prescribed and live a healthy lifestyle. Please contact us anytime if you need help or support. Also, notify the transplant coordinator immediately if any of the following occur prior to your transplant:
- A blood transfusion
- Change in phone number or address
- Planned vacation or going out of town
- Your medical insurance changes
- Your health status changes
- Your caregiver changes
- You’re prescribed new medication
When a compatible donor is available, the transplant surgeon or coordinator will contact you. You will need to come to the hospital immediately. Be prepared to abstain from eating or drinking within hours of the phone call since your surgery will be performed as soon as possible.
When admitted to the hospital, we’ll conduct several tests and an evaluation to make sure you are prepped for surgery. An IV (intravenous) line will be inserted as well.
The actually liver transplant surgery generally takes an average of 12 hours, depending on the patient’s medical condition and previous surgeries. While under general anesthesia, the surgeon will make an incision across the top of your abdomen beneath your ribs and vertically up to your breastbone. The diseased liver and gall bladder are removed and a new healthy liver is sewn into place without a gallbladder. The bile duct is attached, a t-tube may be placed to drain the bile and the incision is then closed. Your transplant surgeon will watch for signs that the liver is healthy and has good blood supply.
After surgery, you will stay in the hospital for about seven days. Your transplant team monitors your progress and helps you walk to prevent complications, build strength and speed up your recovery. Prior to being discharged, the transplant team will instruct you about medications, diet, signs of rejection or infection and everything else you need to know to stay healthy.
You’re expected to return to the Transplantation Institute for follow-up clinic visits and lab tests to track your progress and detect potential complications. Also, you must become an active participant in preserving your health by regularly monitoring certain vital signs including body temperature, blood pressure, pulse and body weight. You must also take your medications appropriately and responsibly for the rest of your life. As you resume normal activities, the transplant team will monitor you closely as you adjust to living with your new liver.
With the accessibility of our facilities and ease of scheduling an appointment, LLUMC's compassionate staff is dedicated to providing you with whole-person care. Our commitment to the well-being of your mind, body and spirit begins with your request for an appointment. Make an appointment by calling us toll-free at 1-800-548-3790 or locally at 909-558-3636, by filling out our online request form or by visiting our facilities today.
Download additional educational materials
The Transplant Patient- English
The Transplant Patient - Spanish
Transplant Patient Welcome Packet
Click here to visit our resoures page for additional helpful information.