The transplant evaluation process: tests, appointments, getting listed, and what to expect during evaluation
The evaluation is a comprehensive series of tests and appointments to determine if you're a good candidate for transplant. It includes blood tests, imaging, cardiac testing, meetings with the transplant team, and more. The goal is to ensure transplant is the right treatment for you.
Typically 2-5 days of appointments spread over 1-2 weeks, though this varies by center. Some centers offer accelerated evaluations. The process may be longer if additional tests are needed or if you have other health issues to address.
Tests include: blood tests (comprehensive metabolic panel, blood count, infectious disease screening, blood type), imaging (CT, MRI, ultrasound), cardiac evaluation (EKG, stress test), pulmonary function tests, and cancer screening. You'll also meet with surgeons, hepatologists, nurses, social workers, and financial coordinators.
Your team includes: hepatologist (liver doctor), transplant surgeon, transplant coordinator (your main contact), nurses, social worker, financial coordinator, dietitian, pharmacist, and other specialists as needed. This team will guide you through transplant and beyond.
No. The evaluation takes time to complete, then the team meets to discuss your case. If approved, you may be listed within a few weeks. Some patients are found to need additional testing or treatment before listing. The process varies by patient and center.
Yes! You can be listed at multiple centers (being "multi-listed"). This can reduce wait time, especially for rare blood types. However, being listed at multiple centers means managing multiple waiting lists and may have additional costs. Some centers may not accept patients already listed elsewhere.
If not approved, the team will explain why. Common reasons include: other health conditions that make surgery too risky, active infection, active substance use, or inadequate social support. Some issues can be addressed (like treating infections or getting sober), after which you may reapply.
After completing evaluation and being approved by the transplant team, you will be added to the national waiting list maintained by UNOS (United Network for Organ Sharing). Your MELD/PELD score determines your priority. The listing process usually takes a few days once approved.
Yes, you can choose which center to be evaluated at. Consider factors like location, volume, survival rates, wait times, and your comfort with the team. You can get second opinions and even list at multiple centers if needed.
Active status means you're ready to receive a transplant and will be offered organs. Inactive status means you're temporarily not eligible (due to illness, infection, travel, or other reasons). You don't accrue waiting time while inactive. Your coordinator manages your status.
Most centers require having a caregiver (family member or friend) to help after transplant. Your caregiver should be committed, reliable, and able to: drive you to appointments, help with medications, monitor your health, and provide emotional support. This is usually required before listing.
Ask about: what your insurance covers, expected out-of-pocket costs, medication costs, pre-authorization requirements, and financial assistance programs. Meet with the financial coordinator early to understand costs and explore options for help with expenses.
Gather: medical records, insurance information, list of medications, questions for the team, and support person to accompany you. Be honest about your health, lifestyle, and support system. Ask questions and take notes. Understanding the process helps you make informed decisions.