Liver Transplant Evaluation
Is it time for a transplant? The decision to undergo a liver transplant is life-changing. It is not just about surgery; it is about ensuring your body is strong enough to accept the new organ. Dr. Srinivas Bojanapu leads a comprehensive 5-Day Evaluation Protocol to assess medical, psychological, and financial readiness.
When is Evaluation Needed?
We evaluate patients when the liver begins to "Decompensate." This means the liver can no longer perform its vital functions, leading to specific complications.
[Image of stages of liver cirrhosis]⚠️ Clinical Indicators
- Ascites: Fluid buildup in the belly requiring frequent tapping.
- Encephalopathy: Confusion, forgetfulness, or drowsiness due to toxins.
- Jaundice: Bilirubin > 3.0 mg/dL persisting despite medication.
- Muscle Wasting: Severe loss of muscle mass (Sarcopenia).
The MELD Score
The "Model for End-Stage Liver Disease" score ranges from 6 to 40. It determines urgency.
- MELD < 15: Monitor with medication.
- MELD > 15: Start Transplant Evaluation.
The 5-Day Evaluation Protocol
We streamline the process to minimize hospital visits. This "Workup" ensures every organ system is checked.
Blood typing, Viral markers (Hep B/C), Kidney function tests.
Why Cardiac? The heart must pump harder during transplant. We do a 2D Echo and Dobutamine Stress Echo.
Triphasic CT Abdomen (Liver Protocol) to map the blood vessels (Portal Vein, Hepatic Artery). This helps the surgeon plan the connections.
Pulmonology check (Lung Function Test), Dental check (to rule out hidden infections), and Gynecologist check (for female patients).
Meeting with the Transplant Coordinator to understand costs, insurance, and the lifelong commitment to immunosuppression medicine.
The multidisciplinary team reviews all reports. If cleared, you are placed on the ZCCK Waiting List (for Deceased Donor) or scheduled for surgery (if Living Donor available).
Contraindications: Who Cannot Have a Transplant?
Sometimes, a transplant is too risky or won't provide benefit. We are transparent about these limitations:
| Category | Contraindication (Reason to stop) |
|---|---|
| Medical | Severe Heart/Lung disease that cannot withstand 10-hour surgery. Uncontrolled Infection (Sepsis). |
| Oncological | Cancer that has spread outside the liver (Metastasis). |
| Lifestyle | Active alcohol or substance abuse. (We require a 6-month sobriety period). |
| Psychosocial | Lack of a dedicated caregiver for post-op support. |