Choosing the Medical Center that is Right for the Liver Transplant Patient

Choosing the medical center that is right for the liver transplant patient.  Fortunately, the liver transplant operation is quite commonplace, thus leaving a host of medical centers in many states that perform this procedure, and perform it well.  How do you find a medical center that may be right for you?  How about word of mouth, our good friend Google, your family doctor, newspapers, and many more ways to find a suitable medical center that are limited only by the imagination.  What are some of the characteristics of a good medical center.  The first ones that come to mind, are liver transplantation success rate and patient care and follow up.  In today’s complicated, competitive medical environment, you would be hard pressed to find a medical center with a low liver transplant success rate.  And patient care rests at the top of most good medical centers too.  A hospital that is lax in its’ given success rates and patient care is soon to be a facility whose days are numbered.  There are also sources on the internet that provide ratings.  (Google seems to be everywhere.)  One other important issue in finding a good medical center is distance from your home.  Distance means time and money, especially at today’s gas prices.   

Liver Transplant Operation – What to Expect

This section is about what to expect before during and after the liver transplant operation.  Since, I have not undergone this procedure, I will be describing it from third party information, such as from other web sites, the attending physicians, and individuals.  After you have qualified for the liver transplant, in addition to packing your bags in preparation for a quick trip to the hospital, you will be waiting and waiting.  Sometimes the wait is short, while many times the wait can be a year or longer.  And this occurs only if your MELD score is around 20 or above.  My MELD score is around 14, so the active process for my liver transplant has not even started.  However, if and when the liver procurement process begins, events go pretty fast. There are no further major batteries of tests to be done, so all you have to do is accept the transplant when you get the call and head to the hospital.  I understand there is about a 3 hour window from liver procurement to the operation.  The operation itself lasts approximately 6 to 12 hours and has a high success rate in the 90% or higher range.  Five year survivability is very good too, being somewhere around the mid to upper 80% range.  I am not quite sure where the greater than 5 year survivability statistics went.  Maybe, they figure no more statistics are needed if you make it 5 years. I have talked with a liver transplant patient, who has survived over 15 years and is leading a normal life. When the liver transplant operation is completed, the first 48 hours is the most critical time.  The medical staff will be monitoring for excessive bleeding, clotting and infection. There also will be tubes and machines hooked up the liver transplant patient for the first 2 to 3 days. You can expect your stay in the hospital to last about 10 days to 2 weeks.  I have talked to patients that told me they felt much better when they woke up from the liver transplant operation.  The medications you will be taking are mainly anti-rejection and immune-suppressant drugs.  I understand they are quite expensive.  The most expensive part of the liver transplant patient is the transplant itself, however, which runs around $300,000, give or take.  When the liver transplant patient leaves the hospital, a fairly normal life can be lead with proper care and absolutely no alcohol use.  There will be follow up visits, which will be gradually decreasing in frequency as long as the liver transplant patient continues to recover normally.     

Insurance and Payment Considerations for the Liver Transplant Candidate

Insurance and payment considerations for the liver transplant candidate are an important factor in the liver transplant process.  The hospital I am presently working with, which is the Ohio State University Medical Center in Columbus, Ohio, has been very helpful in answering these cost issues.  The ideal situation is to have medical insurance covering any and all costs.  Many times the ideal situation is not always the case.  However, there are answers that can help almost any liver transplant candidate.  If a limited medical policy exists, or no policy at all, there is still help.  And, to debunk a myth, hospitals will not always turn you away because you cannot pay for the services rendered.  All they ask for is a good faith effort to try to pay what you can on a regular schedule.  There are also state and federal agencies, such as the state job and family services agency or social security.  There is also our old friend Google that will provide a wealth of information.  

The Liver Transplant Candidate Makes it on the Transplant List and Gets to meet the Transplant Team.

The liver transplant candidate makes it on the transplant list and gets to meet the transplant team.  Finally, in 6 to 8 months, after all the diagnostic testing, meetings, therapy sessions, state board approval, and the like the liver transplant candidate is on the transplant list, and you get to meet with the transplant team.  Shortly after approval, you will be sent a brochure that explains all about liver transplants, the surgical procedure, and all kind of details about the liver transplant surgery.  Soon after you receive your brochure, a meeting will be set up for you and your family to talk with the transplant team and have any questions that you might have.  Although approval is an important step, there is waiting, follow up testing, and insurance approval.  How long is the wait?  Anywhere from 1 to 4 years.  What is the reason for this waiting process?  Unfortunately, there are not enough donor livers to satisfy the demand, which keeps growing. Currently the ratio of liver donors to livers needed  is around 1 in 8 or so.  So this is a major reason for the wait.  Then cell matching must be accomplished, and also your MELD score needs to be generally at 20 or above to receive a new liver.  So should the liver transplant candidate be discouraged?  Not really – there is always hope.  Also, in the vast amount of cases involving cirrhosis, the condition progresses very slowly, if the liver transplant candidate takes proper care of himself and absolutely abstains from any alcohol.  In my case, my MELD score is 14.  My doctor has told me I may never need a transplant.  He has seen many liver transplant candidates with the same or similar MELD scores live over 20 years until a transplant is necessary.