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Evaluation for Liver Transplantation

Medical Testing

Candidates for liver transplantation undergo thorough medical and psychiatric evaluations. Medical tests may include:

Cirrhotic liver stained with trichrome stain
Cirrhotic liver stained with trichrome stain.
Diffuse scarring (excess collagen) appears
blue; rounded regenerative nodules
(hepatocytes) appear red.
  • blood tests,
  • heart tests,
  • lung evaluations,
  • liver biopsy,
  • and more.
Microscopic comparison of normal liver biopsy with hepatocellular carcinoma
Microscopic comparison of normal liver
biopsy (left) with hepatocellular carcinoma

Imaging testing may include:

  • chest x-ray to determine the health of the lungs;
  • ultrasound to examine the liver, abdominal organs, and blood vessels;
  • CT scan of the liver;
  • MRI of the abdominal organs and blood vessels;
  • endoscopy to assess ulcers or inflammation in the esophagus and stomach;
  • ERCP (Endoscopic Retrograde Cholangiopancreatography) to view the bile ducts;
  • Liver angiogram.
Psychosocial Evaluation

It is vital that all potential transplant recipients have support systems in place to help them throughout the process. A psychosocial team evaluates potential candidates and their families or support teams, and assists patients with psychosocial needs. Social support services are available to patients and their loved ones to help them cope with the many issues that arise during the transplantation process.

Lorna M. Dove, M.D.
Lorna M. Dove, M.D.

The Center strongly recommends that patients take advantage of its educational resources, support groups, and other services, because patients and families both benefit greatly from the information and support they provide.

Substance abuse screenings may be conducted at random during this process; use of alcohol or illicit drugs will render patients ineligible for liver transplantation.

Financial Planning

During the evaluation period the Center's financial counselors meet with patients to verify that their insurance will cover the cost of liver transplantation, including post-operative medications. If insurance coverage is insufficient, the Center's counselor and social worker assist patients in finding alternative solutions.

Waiting for a Liver Transplant

The length of the waiting period for liver transplantation varies depending on the type of transplant to be performed, severity of illness, and other factors. During this challenging period, it is important for patients to:

  • maintain their physical and emotional health
  • maintain close contact with the transplant team
  • be prepared to travel to the hospital at a moment's notice when a donor organ becomes available.

Robert S. Brown, Jr., M.D., M.P.H., discusses how a MELD score is calculated and determines where patients are placed on the waiting list for a new liver. Before and after this, he also discusses the option of living donor liver transplants.

Staying Healthy Before Transplantation

The Center encourages patients to stay as healthy as possible by managing stress, eating well, and staying active so that they are ready for transplant surgery as soon as a donor organ becomes available. For patients who have a living organ donor, scheduling transplant surgery can take into account the health status of the recipient as well as other factors. Patients will come to the Center for regular checkups during this waiting period.

Education and support groups at the Center provide patients with tools and support to manage their stress and cope with the challenges associated with their condition. A nutritionist will provide dietary recommendations to help address health problems associated with liver disease including:

Dr. Samstein reviews scans
Dr. Benjamin Samstein reviews scans.
  • fatigue,
  • nausea,
  • food intolerance,
  • fluid buildup (ascites),
  • diarrhea,
  • and edema.

Regular exercise at home is encouraged in order to preserve patients' endurance, strength, mobility, flexibility, and easier breathing.

In living donor transplants, both donor and recipient will undergo pre-surgical testing one week prior to surgery.

Staying in Touch

Patients on the deceased-donor waiting list must be reachable at all times. Pagers or mobile phones are not mandatory, but may be the best mechanism for reaching patients immediately when a donor liver becomes available. Transportation to the hospital should be planned in advance so that when a donor organ becomes available, patients and their families already know:

  • the route,
  • form of transportation,
  • who will accompany the patient,
  • how travel expenses will be covered if necessary,
  • and other details.


Center for Liver Disease and Transplantation
(877) liver-md
Weill Cornell
Center for Liver Disease and Transplantation
(646) 962-liver

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