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Transplant Services

Liver Transplant Program

For over 20 years, the surgeons and transplant specialists at the Medical University of South Carolina have been helping patients across South Carolina – and beyond – live happy and productive lives.

About Us 

Our patient-centered approach is designed to work with you before, during and after a liver transplantation. MUSC has one of the shortest wait times in the country, improving the odds of finding a new liver.  You can stay at your home while you are waiting. And MUSC is nationally recognized for having a very high survival rate. MUSC has some of the best physicians and surgeons, the latest technology, stare-of-the-art facilities, and is located in Charleston, South Carolina, one of the most beautiful cities in the world.

Superior outcomes

The MUSC program has some of the nation’s highest liver transplant survival rates and  some of the nation’s shortest lengths-of-stay.

Clinical trials

Our goal is to develop the safest and most successful procedures and drugs through extensive research at one of the country’s leading teaching hospitals.

Is Liver Transplant Right for You? 

Transplantation is a complicated process and can put an enormous strain on your body. You must be healthy enough to handle the stress of the surgery and the post-transplant recovery. Ask your doctor if transplantation is right for you.

Most patients come to the MUSC Liver Transplant Program for treatment of:

  • Cirrhosis of the liver (liver disease): hepatitis B, hepatitis C and fatty liver disease (NASH)
  • Fulminant and subfulminant hepatic failure
  • Hepatocellular carcinoma (HCC)

Being selected as a good transplant candidate is based on onsite evaluation and a thorough review of a patient’s:

  • Current health condition
  • Past medical history
  • Psychosocial history
  • Lab results
  • Medical testing
  • Financial status

UNOS Waiting List for a Liver Transplant 

MUSC physicians do not decide who is next to receive a liver from the transplant waiting list.  After the evaluation, eligible patients are placed on the UNOS transplant waiting list. The MUSC Transplant Center’s wait times for an available liver are among the shortest in the nation. UNOS has a pre-determined process for prioritizing candidates waiting for liver transplants based on statistical formulas that are very accurate in predicting who needs a liver transplant most urgently.  The MELD (Model for End Stage Liver Disease) is used for patients age 12 and older. The PELD (Pediatric End Stage Liver Disease Model) is used for patients age 11 and younger.

How to Prepare for Your Liver Transplant 

The liver transplant process

  1. Discuss your options with your primary care physician/GI physician
  2. Complete the online referral form
  3. Get a pre-transplant assessment at MUSC Health or a local transplant center
  4. After being deemed a suitable liver transplant candidate, you will being given an “Active Status” on the United Network for Organ Sharing (UNOS) list
  5. Maintain a good health status
  6. Complete all pre-transplant tests
  7. Be prepared to respond immediately when a liver is available

To be sure that you are healthy enough to have a successful transplantation, here is what you should expect to do before your assessment by the MUSC Health Transplant Center and your listing with UNOS. Unlike many transplantation programs, you will not have to move to Charleston while you are waiting and you may complete many of the necessary steps near your home.

Routine medical examinations at MUSC

Before being given a “Listed with Active Status” on the UNOS list, patients will undergo an extensive medical examination of body systems and corresponding tests to determine their ability to have a transplant. Tests include:

  • Blood work, including blood typing
  • Urine testing, including a 24-hour collection for kidney function
  • EKG – electrocardiogram to assess heart condition
  • Ultrasound of the abdomen to look at liver and blood vessels that connect to the liver
  • Skin tuberculosis test (TB)
  • Other types of x-rays, such as CT scans, MRI, heart and lung tests
  • Possible liver biopsy
  • Transplant hepatologist evaluation
  • Transplant surgeon evaluation
  • Social worker assessment
  • Financial coordinator consult
  • Nutrition consult
  • Consult with other healthcare professionals, as necessary

To speed up the process of getting on the UNOS list, patients should complete the following health maintenance testing prior to their evaluation at MUSC:

  • Mammogram and PAP smear for females
  • PSA for men over age 40
  • Colonoscopy for patients over age 50
  • Oral health clearance from a dentist

The results of these tests ensure that patients do not have a hidden infection or cancer that would lead to denial of transplantation. In addition, patients must follow the MUSC Liver Transplant Program substance abuse and alcohol policy, which states that they must be abstinent from alcohol and addictive substances at all times and for at least six months. Random alcohol and drug screenings can be given at any time.

Patient and family education

We want patients and caregivers to know as much as they can about liver transplantation, so they can make the right choices. During the evaluation process, you and your family will learn more about:

  • The review committee
  • Planning specifics
  • The actual surgery
  • Transplant clinic following surgery
  • Living with a transplant

When a liver is available

Planning for a liver transplant includes the following:

  • Determining what clothing and personal items will be needed at the hospital.  A list is helpful to avoid last-minute stress.
  • Deciding who will come to the hospital.  Write down phone numbers so they are readily available.
  • Having directions to the MUSC Transplant Center.  Write these down and call us in advance to verify.

What to Expect at MUSC Health 

The MUSC Health patient-centered approach is designed to work with you before, during, and after a liver transplantation.  A comprehensive team of transplant-certified specialists will help guide you through the process and provide the kind of care you expect from one of the nation's leading teaching hospitals.  Our goal at the MUSC Transplant Center is to provide the patient and family with key information about the pre-transplant evaluation and listing process, transplant surgery, and post-transplant care, so you can make an informed decision about transplant and successfully participate in your post-transplant care.

Surgery

The procedure takes about six to eight hours. The incision will be closed using staples. After the surgery, you will be transferred to the intensive care unit where you will stay for about 24 hours. You will then be transferred to the Organ Transplant Unit.

Hospital stay - Organ Transplant Unit

You can expect to stay in the Organ Transplant Unit for four to seven days. The nursing staff and transplant team will monitor you to see how well your new liver is functioning. You will probably starting eating solid food in a day or two – although your diet will be different. And you will stand and walk short distances on the first or second day after surgery.

Discharge

When discharged from the hospital, you will move to a nearby hotel or other local housing arrangements. You don’t need the intensive care of a hospital, but we do want you close for several weeks and up to 3 months as needed, so we are certain you are recovering well enough to go home.

The MUSC Health Transplant Team will work with you and your family to prepare for care at home. We will provide a booklet on how to manage your post-transplant care and make an appointment with our local post-transplant clinic to monitor your progress. Your team is available 24 hours a day, 365 days a year to answer any questions you may have.

Care after your transplant surgery

Patients and their caregivers will receive post-transplant educational materials to learn:

  • How to care for the liver
  • How to care for themselves after they are discharged, including monitoring of lab values
  • About their new medications and how frequently these must be taken
  • About possible complications, such as rejection and infection

The biggest concern post-surgery is organ rejection. That’s when your body recognizes the new liver as a foreign object and tries to get rid of it. You will be taking immunosuppressive – or anti-rejection – drugs. These are absolutely necessary, but sometimes they have side effects. You may also be taking medicines to prevent infection, anti-hypertensives (for high blood pressure), vitamins, diuretics (water pills), antacids, etc. Some of these medicines may only need to be taken for a short time, while others may be continued for other medical conditions you have. If another doctor prescribes medication for you, it is wise to let the transplant team know to make sure that they do not interfere with your immunosuppressive medicines.

Remember, transplantation is a treatment, not a cure. So you have to take good care of yourself. Your post-transplant team will work with you to be sure you are doing everything you can to have a successful recovery. The MUSC Health Transplant Program has an excellent success record. You should enjoy a high quality of life.

After being sent home, patients can receive monthly care here at MUSC.  If you live out of state, the MUSC Health Transplant Team will coordinate with your primary care physician.  Once at home, patients increase the chances of their transplant being successful by:

  • Taking new medications as directed
  • Washing hands frequently
  • Avoiding sick people
  • Wearing gloves when gardening

 

To contact the MUSC liver transplant program, please call 843-792-0332.