Frequently Asked Questions
How long will
I have to wait for a liver?
The waiting time for an organ has increased
dramatically as the demand for livers far outweighs
the supply. Because of the high risk of death
of those patients with end-stage liver disease
while waiting on the list, the United Network
for Organ Sharing (UNOS) has developed the Model
for End-stage Liver Disease (MELD)/Pediatric Model
for End-stage Liver Disease (PELD) scoring
system. This system is used in conjunction with
blood type factors. Traditionally, patients with
blood type AB have the shortest waiting time followed
respectively by A, B and blood group O.
Therefore, once you are "listed" on
a liver transplantation waiting list, obtaining
a liver transplant depends on several factors,
including:
- Your blood type
- The number of other patients listed within
the local area
- The severity of liver disease of the other
patients listed in the local area
- The number of organs available in the local
area or region
In an effort to transplant patients in a timely
manner, the Penn Transplant Center is attempting
to increase the donor pool through adult-to-adult
living donation and "split liver" procedures.
In adult-to-adult living
donation, either a full right side or full
left side of a liver from a healthy adult is transplanted
into another adult with end stage liver disease.
The liver segments regenerate in two to six weeks
on average.
Because of the unique regenerative quality of
the liver, a "split liver" procedure
allows the surgeons to divide a donated liver
and transplant each portion into two separate
patients.
How is the waiting
list structured?
What is MELD?
The Model for End-stage Liver Disease (MELD)
is a continuous disease severity scale that
is highly predictive of the risk of dying from
liver disease while awaiting liver transplantation.
The MELD score incorporates objective criteria,
including bilirubin, INR and creatinine levels,
in an equation to determine the patient's disease
severity. It allows for allocation of organs
to the sickest patients.
How is waiting time used?
Waiting time is used only to break ties among
patients with the same MELD scores and blood
type compatibility. The donor organ is matched
to the recipient based on blood type and body
size. Organs are not allocated by income, gender,
race, age or diagnosis.
Can I be on the waiting list at two different
transplant centers?
Liver transplant candidates can be listed at
more than one transplant center.The allocation
of livers for transplantation is done by region.
It is not unusual for a patient to be listed
at Penn and at a center in another state. You
cannot be listed at two centers within one region
because we receive organs from the same pool.
However, it is important for you to keep the
transplant centers informed about any change
in your health status or contact information,
so that your placement on the waiting list can
be adjusted, if necessary, and so that the transplant
centers can reach you quickly in the event that
an organ becomes available for you.
How can
I find out about medical coverage for my transplant?
All patients meet with one of our Penn Liver
Transplant Program financial counselors during
the initial evaluation day. Medical insurance
is reviewed to determine what expenses are covered,
including medications. The counselors will assist
patients with managed care referrals, changing
insurance carriers and prescription coverage issues.
What kind
of social support does the Penn Transplant Center
offer to patients?
Social service is an integral component of
our transplant team. A specialized transplant
social worker and psychiatrist are involved at
the time of your initial evaluation and provide
support throughout all hospitalizations and in
the outpatient setting.
Revised by Kim
Olthoff, MD
Last updated February 2006
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