Multi-Organ Transplant

Liver Transplant - Patient Information

Overview Clinics Research Staff Patient Information A - Z Glossary Map & Directions Health Professionals Fellowships

The Multi Organ Transplant Program of the Toronto General Hospital performs 120-150 liver transplants per year. Our first liver transplant was in October 1985. More than 1000 deceased donor liver transplants have now been performed. Our living donor liver transplant program started in April 2000. With 40-50 adult-to-adult living donor liver transplants per year has become the largest in North America.

Evaluation
Pre-transplant evaluation consists of a variety of medical tests and interviews with members of the transplant team. This process is essential in determining a patient's suitability for liver transplant.

During the evaluation process the potential candidates and their family or support persons will be provided with information to assist them in making informed decisions about the operation and post-operative period. The patient and their family are encouraged to ask questions. The length of time required for proper for evaluation varies according to the specific needs of each individual patient.

The workup process typically involves evaluation of the heart and vascular system, lung function tests, specific liver tests, and standard evaluation by our psychiatric and social work team. Additional investigations might be necessary based on the individual need.

The Transplant Team Members who consult on liver transplant evaluation are:

	Hepatologist
	Liver Transplant Surgeon
	Anesthetist
	Transplant Coordinator
	Social Worker
	Psychiatrist / Psychiatric Nurse
	Physiotherapist
	Occupational Therapist
	Nutritionist

Waiting List
Once the assessment is finished the transplant team reviews the results. If there are no contraindications the candidate is placed on the liver transplant waiting list. There are presently over 200 patients on the waiting list for liver transplant within our program. The waiting period for a donor varies in length because the donor pool is limited and the selection criteria for a matching donor are strict. It is not possible to predict when an organ will become available. The waiting time can be minimized if the patient has a living donor, who is willing to donate a part of his liver.

Surgery
Once the donor organ is deemed to be suitable for transplantation the surgery takes usually 4 to 8 hours. The operation consists of complete removal of the diseased liver (including gallbladder) and implantation of the new liver. Implantation of the new liver includes connecting blood vessels supplying the liver (hepatic artery & portal vein) and structures draining the liver (liver veins, bile duct).

Recovery
Liver transplant should expect to be in the hospital for approximately 7-14 days after surgery. Some patients may need longer hospital stays to recover from surgery. After the transplant procedure, patients are assisted with breathing by a ventilator and monitored in the intensive care unit. Once stabilized, the ventilator is removed and patients are then transferred to the Multi Organ Transplant Unit.

Discharge & Follow-up
Discharge planning begins well in advance and patients meet with the program's Patient Resource Coordinator who assists in determining the patients' readiness for discharge and ensuring patient teaching is complete.

After transplantation the patients will be followed in the Post-Transplant Clinic. The frequency of clinic visits decreases over time in stable patients. Communication with the patient's family physician and other specialists is an important component of follow-up care. Regular bloodwork monitoring and strict adherence to medications as prescribed help ensure the best possible outcome.
Patients keep in contact with their transplant team through our patient voicemail system, Easy Call.
Our team approach ensures that patients receive comprehensive transplant specific follow-up care after their transplant.

[back to top]
[back to Liver Transplant homepage]