UCHealth’s liver transplant team, based at University of Colorado Hospital, is unmatched in volume by any other program in the Rocky Mountain region. We perform over 80 liver transplants annually.
Why choose UCHealth for your liver transplant?
The first liver transplant in the world was performed at our hospital in 1963 by world-renowned surgeon Thomas Starzl, MD. Since pioneering this surgery, we’ve performed thousands of liver transplants in adults and children. We also have extensive experience in performing living-donor liver transplants.
Under the leadership of Igal Kam, MD, we’ve made significant technological and treatment advances that greatly increase the likelihood that liver transplant patients lead a normal life after transplant surgery. At University of Colorado Hospital (UCH) in metro Denver, we devote an entire floor to transplant patients.
It’s reassuring to know that:
- Our one-year survival rate is one of the highest among centers performing over 60 liver transplants per year.
- You’ll receive medical care from a team of experts specifically trained to address the special needs of transplant patients.
- The average hospital stay from date of transplant to discharge is 12 days.
Types of liver transplants
A cadaver transplant uses the liver of a person who is brain-dead. This is the most common type of liver transplant.
Living donor transplant
As the name suggests, a living donor transplant comes from a live person, usually a relative or close friend who donates a portion of his/her liver to the person in need of the transplant.
Your health evaluation for transplant
Before you receive a liver transplant, you’ll have a series of tests to determine your current health. After these tests are performed, various members of the transplant medical team will conduct a thorough evaluation.
A hepatologist will present your case to the Patient Selection Committee for Liver Transplantation, which meets on a weekly basis. They determine whether transplant surgery is safe for you. They also will discuss an optimal plan of care for you after transplant.
Your hepatologist or transplant nurse coordinator will inform you of the committee’s decision and plan. Your coordinator will notify you if/when you are placed on the active transplantation waiting list or registry.
Once you are on this list, be prepared to come to the hospital at any time of the day or night.
Liver transplant waitlist
The UCH Transplant Program follows the United Network for Organ Sharing (UNOS) system for prioritizing transplant candidates. UNOS is a nationwide network supervised by the federal government to help ensure that all patients receive healthy organs as soon as they become available. All transplant centers in the United States belong to UNOS.
For this system to work, it relies on organ procurement organizations, called OPOs. OPOs match and distribute donated organs, 24 hours a day, 365 days a year. The OPO in our region is Donor Alliance (DA). DA is responsible for the coordination, retrieval, and distribution of organs in Colorado and Wyoming.
Matching Organs to Patients
The process of matching donor organs to patients awaiting a transplant is based on a point system. Points are given for several factors, including:
- Medical urgency of the transplant candidate
- Time spent on the waiting list
- Biologic compatibility (organ size, blood type, etc.)
- The candidate’s ability to be transplanted immediately
If all candidates are of similar degrees of illness, the donor organ is offered to the person with the longest waiting time.
Donated organs are distributed locally first. If no suitable match exists in the local area, the organ is offered regionally and then nationally.
During the waiting period, you will be monitored by your hepatologist. Your hepatologist will keep the transplant surgeon and coordinator informed about changes in your condition.
If you live far away from UCH, your care may be managed by your primary care doctor. You also will be given guidelines about diet and exercise.
Liver transplant surgery
After you have received a call to come to the hospital, you’ll be admitted to the transplant unit where preparation for surgery begins.
Preparation for surgery
You may have some preoperative tests done and be given some medications.
Surgery will not begin until the donor liver arrives at the hospital and is examined by the transplant surgeon and determined to be acceptable.
Once the medical team decides to proceed with your surgery, you’ll be given an anesthetic to put you to sleep for the procedure.
Liver transplant surgery can be divided into three stages:
- Removal of the old liver
- Replacement with the new liver
- Reconstruction of the biliary tract (bile duct system of the liver)
During the procedure, an incision shaped like an upside-down T is made on the upper part of your abdomen. Your old liver is removed and replaced with the new organ, leaving major blood vessels in place. The new liver is then attached to these blood vessels and bile ducts.
Although various factors affect the complexity of your surgery, the procedure generally lasts five to eight hours.
After surgery, some patients stay in the Intensive Care Unit (ICU) for a short period and then return to their rooms for recovery. Others go directly from surgery to their rooms.
The amount of time a patient is in the hospital after liver transplant surgery varies. It can be as little as one week, barring complications.
You may return to work as early as six weeks after surgery. Depending on your condition, however, it may take longer.
Monitoring your recovery after discharge
Your liver function will need close monitoring for the first several months after you leave the hospital. Because most complications are seen in the first few months, we recommend you wait six months after transplant surgery before planning a vacation or long-distance trip.
Initially, you’ll be seen twice a week in the liver transplant clinic. You’ll need to have blood tests done at least once a month as long as you have your new liver. Although your risk for rejection and infection will decline over time, it’s never completely gone.
Your follow-up visits will be more flexible once your wound is healed, your liver function is normal, and your medication dose is adequate. Once this happens, you may have your blood tests done at a location closer to your home. If you live outside the Denver area, your transplant coordinator will arrange for your follow-up care to be managed by your local doctor and lab facility.
The liver transplant team will continue to follow your progress as long as you have your new liver. We encourage you to return to UCH’s Transplant Center for a checkup once a year.
Diet and exercise after transplant
Exercise and diet after transplant are very important factors in feeling well again. Because excessive weight is very unhealthy for your new liver and your general well-being, we recommend that you limit calories and exercise regularly.
Post-transplant patients are encouraged to resume or begin a regular exercise plan when they leave the hospital. Exercise for transplant patients has been shown to increase endurance and muscle strength, enhance bone remodeling, and reduce the need for anti-hypertension medication.
Proper nutrition also is critical for post-transplant patients. Certain medications you take will affect the way your body processes food. You will receive medication guidelines related to your diet.
Your dietitian at the hospital will help you create meal plans that are both nutritious and low in calories. Following your diet is important to the total rehabilitation process and to maintaining good health throughout your life.
Patient and family education sessions
Patients who are on the UCH waiting list are welcome to attend the class titled “The Process of Liver Transplantation.” Our transplant coordinators teach the class every Wednesday morning from 9:30 a.m. to 11:00 a.m. Please give us a call at 720.848.0840 if you would like to attend.
Another education option is the Rocky Mountain Liver Transplant Support Group, a support group led by post-transplant patients. This support group is for those patients on the waiting list as well as patients who have had a liver transplant. The group meets on the second Monday of each month from 9:30 a.m. to 11:30 a.m. in the Anschutz Outpatient Pavilion.
For more questions, please call any of the following contacts: