Certain chronic (long-term) and acute (sudden) medical conditions can cause your liver to stop working. This is called liver failure. And while liver failure can be a serious threat to your health, a liver transplant can offer hope for a fuller, longer life.
Surgeons in our Liver Transplant Program regularly and successfully perform liver transplants on patients with complex conditions. We use innovative treatments including living donor liver transplantation, split liver transplantation, normothermic regional perfusion (NRP), and normothermic machine perfusion (NMP) to help make liver transplant an option for more patients. Additionally, these methods are paired with innovative oncologic treatments such as SBRT, Y90, and thermal ablation to offer patients with primary or metastatic liver cancer a potential cure.
Our care teams thoughtfully evaluate your condition and circumstances before they decide if liver transplantation is right for you. Our surgeons are experienced in performing liver transplant surgeries to successfully treat several conditions that may lead to liver failure, including:
Most liver transplant recipients are in end-stage liver disease, and, with a liver transplant, their life expectancy can dramatically increase. More than 10,000 people in the United States benefit from a liver transplant each year. For individuals who are waiting for a new liver, it’s important to understand the factors that lead to long-term survival and the criteria for transplant eligibility.
There are more than 9,000 people on the waiting list for a new liver, according to the United Network for Organ Sharing. The Model for End-Stage Liver Disease (MELD) scoring system is one way the AHN transplant team determines who receives a liver transplant. Other factors include blood type and the presence of disease beyond the liver.
A new liver is a gift that needs to be cared for, so a potential recipient’s lifestyle may also be considered. To be a candidate for a life-saving liver transplant, the patient must abstain from alcohol and drugs, as well as be both physically and emotionally capable of undergoing a difficult surgery and the complex schedule of medications that will follow liver transplant surgery. A patient doesn’t need to endure these challenges alone. At AHN, we see you and are here to provide the expertise and support you need before, during, and after a liver transplant. Liver transplantation at Allegheny General Hospital is conducted by a multidisciplinary team that provides preparatory and follow-up care. This means you can focus on recovery while our team focuses on all the physical and emotional health needs.
The AHN Transplant Institute uses groundbreaking techniques to help patients with primary and metastatic liver tumors become candidates for transplant. To be eligible for a transplant, the number and size of the tumors must meet strict national guidelines set by the United Network for Organ Sharing.
When someone has liver cancer along with a damaged liver (cirrhosis), a liver transplant is often the best and only way to treat both problems at once. It removes the cancer and replaces the sick liver with a healthy one.
Liver transplants can also be a treatment option for other types of liver cancer, like bile duct cancer, especially if surgery to remove the cancer isn't possible.
Sometimes, cancers that begin in other parts of the body, such as the colon, small bowel, or pancreas can spread to the liver. In certain cases, a liver transplant might even be considered for these 'spread' cancers, offering a chance for a cure when other surgeries aren't an option.
While patients are waiting for a liver transplant, or if they're not quite ready for one, doctors can use special localized treatments to target the cancer in the liver. These treatments include focused radiation (SBRT), special radioactive therapy (Y90), and heat treatments (thermal ablation). These methods help control the cancer and improve the patient's chances. They can also be used alongside other cancer-fighting drugs like chemotherapy or immunotherapy.
A traditional liver transplant takes the organ from a deceased donor. AHN is one of the few medical centers around the country that performs living donor liver transplants. This highly sophisticated procedure provides an additional lifesaving option for some patients with end-stage liver disease. The procedures occur simultaneously. In the following few weeks, the livers of both the donor and recipient will regrow to the size of normal livers.
Based at Allegheny General Hospital, our dedicated Liver Transplant Program team offers comprehensive liver transplant care that’s personalized to your needs. Our multidisciplinary specialists work together to make lifesaving liver transplant possible for as many patients as possible.
Highlights of our program include:
Our team-based care saves you time and energy so you can focus on your health. We also teach you about every part of transplant care, helping you make the most of life after liver transplantation.
Our multidisciplinary care means professionals with different backgrounds and specialties participate in your care. Everyone on our team has received specialized transplant training. They work together to ensure your physical, mental, and emotional health before and after liver transplant surgery.
At AHN, your care team includes:
We’re committed to making the benefits of liver transplant a reality for as many people as possible. That means we consider transplantation for people with complex medical circumstances when other centers won’t. Our surgeons’ medical expertise, along with thorough health evaluations, help us deliver excellent results to even the sickest patients.
Your primary care physician or gastroenterologist (digestive and liver disease specialist) will call our surgery institute if they believe you may benefit from a liver transplant. You may also call us yourself if you’d like to learn more about whether a liver transplant could be right for you.
Next, a member of our transplant team will call you to schedule certain tests. This testing will help us understand your health and make your first appointment with us more productive. This evaluation will be an opportunity for you to talk with the transplant team about questions or concerns you may have.
At your initial evaluation, you will meet with several members of our transplant team. In our transplant clinic, located at Allegheny General Hospital, our specialists work together in one place to save you time and energy.
They’ll discuss your test results with you and review the transplant process with you. They will also explain how a liver transplant could affect your life. Our team is available to answer your questions, at this meeting and anytime after.
Our liver transplant team meets together to discuss every patient’s case in great detail. If we think you will make a great candidate for liver transplantation, we will put you on a national liver transplant wait list. The United Network for Organ Sharing (UNOS) calls us when a donor organ becomes available for you.
How long you wait for a suitable donor organ depends on several factors, such as the severity of your condition. Your position on the list (based on your MELD score) gets updated as you undergo regular blood work and testing. A higher MELD score means your health is declining —but it also increases your chances of getting a donor organ.
This waiting period can be stressful for patients and their families. You can call our team anytime if you have questions or concerns about the process.
If a donor organ becomes available, our transplant coordinator will call you right away. We ask all patients on the liver waiting list to be reachable at all times of day or night. If a donor organ becomes available, you will need to come in for surgery immediately.
All liver transplant procedures take place on a dedicated transplant floor at Allegheny General. Transplant specialists will care for you during your entire hospital stay. A liver transplant procedure may take four to eight hours to complete.
After liver transplant surgery, patients stay in the hospital’s intensive care unit (ICU) for a few days so we can watch your health closely. Once we’re confident that your condition has improved, we will move you to a room where you can continue to recover.
You can expect to stay in the hospital for 10 to 14 days after your surgery. In the days and weeks that follow, we track your health closely.
Life after liver transplant will be different in expected and unexpected ways. You’ll have more energy to experience life in a way that wasn’t possible before. But first your body will need to fully recover from surgery.
Many people feel different levels of tiredness and pain right after surgery. This is normal and will lessen with time. Some spend time in a physical rehabilitation unit before going home. Physical therapy can help shorten the recovery process.
You will need to take important medications starting right after your surgery — and for the rest of your life. These medications are called antirejection immunosuppressants. They help your body get used to your new donor liver. At AHN, we offer patients advanced, steroid-free medications. They help you avoid some of the negative side effects other medications may cause.
While you’ll see us less often over time, we’ll play some role in your care for the rest of your life. We’ll make sure you have the tools and information you need to make the most of life after transplant.
We’ll also teach you the common signs that may point to infection or organ rejection. The sooner you alert us to potential problems, the faster we can provide treatment.
Your commitment to your care is important to your transplant success. Our team will tell you exactly which medications you need to take (and why). In the beginning of your recovery, you will need to go to a local hospital or lab testing clinic for regular blood work. These test results help our team track your health and liver function.
In time, your primary care physician or hepatologist will take over the more routine parts of your care. But we’ll remain in contact with your local physician to monitor your health. We’ll also evaluate you at yearly appointments for the rest of your life.
Awaiting a liver transplant can be challenging and emotional. At AHN, we are here to provide you with the support, resources, and guidance to hopefully make the process a little less overwhelming. Your care and transplant team will be with you to answer your questions and create a plan that is tailored to your specific needs. To help you feel confident and ensure you are getting the information you need, we’ve compiled answers to some frequently answered questions our patients have about the liver transplant process. You can use this information as a guide for when you meet with your care team.
This is general information to use as a resource prior to your liver transplant. Your AHN care team will provide you with a specific and tailored plan to help you prepare for your liver transplant.
Your gastroenterologist, primary care physician, or other medical provider can contact the transplant office by calling 412-359-6800 and choosing option 5 for liver. Patients may also use this number to inquire about the program.
We are a Medicare-approved program and accept many different insurance plans. Our financial coordinators will confirm your insurance coverage before your initial evaluation.
Before your initial visit, you will be contacted by the transplant team to schedule a variety of tests to assess your medical condition. At your evaluation appointment, you will meet several members of the transplant team to review the test results and discuss your medical history. These team members include a nurse coordinator, a transplant surgeon, a hepatologist (liver doctor), a psychiatrist, a social worker and a financial coordinator. The transplant process will also be reviewed in great detail to answer any questions you and your family may have.
After you meet the team and have undergone all the recommended testing, your case will be reviewed by our liver transplant team. If the team determines that a liver transplant is the best option for you, the nurse coordinator will contact you to discuss the donor list process.
A nurse coordinator will remain in close contact with you throughout the waiting period. You will also continue to follow up with your regular gastroenterologist. Keep in mind:
If a possible liver becomes available for you, you will be contacted by a transplant nurse coordinator to report to the hospital. Final testing will be done on the donor liver to determine whether to proceed with the transplant.
Preparation for a liver transplant is a thorough and specific process that is critical for a successful transplant. Your AHN care and transplant team will provide you with a plan that is tailored to your needs, but generally, you may expect the following:
These are all general ways people can prepare for a transplant. Prior to any surgery, your team will help you understand what your specific plan will entail.
You will receive specific pre-operative instruction when the transplant coordinator notifies you about the transplant.
You will be in the Intensive Care Unit (ICU) for several days, so there is no need to pack anything for when you initially arrive at the hospital for your transplant. AHN will provide you with everything you need to recover and heal. As your health improves, your support people — family or friends — can bring you what you need. Having a discussion with this team prior is a good idea so they know what you might want. Please leave your valuables at home.
The Transplant Institute is at Allegheny General Hospital, which is located at 320 E North Ave., in Pittsburgh.
You may park in the James Street garage at Allegheny General Hospital.
If a bed is immediately available, the transplant coordinator may ask to you to proceed directly to the assigned room in the hospital. Otherwise, you may wait in the Admissions Department where you will be contacted as soon as the bed becomes available.
As a liver transplant patient, you will be admitted to the ICU after surgery until you are ready to proceed to a regular room. Every effort is made to provide transplant patients with a private room.
All of our patients' rooms are equipped with televisions and telephones.
We have relationships with several hotels in the area that offer discounted rates and shuttle services to Allegheny General Hospital. Our transplant social worker can supply you with an up-to-date list of these hotels.
Yes, we provide a number of special services for hospitalized patients with disabilities. During the admission procedure, please let our transplant coordinator know of any special needs that you have to make you as comfortable as possible while you are here.
Your liver transplant procedure is a detailed and involved process. Your care team will give you specific information and instructions on how to prepare and what to expect, but to help give you some background, we’ve included some frequently asked questions from patients that will help educate you on the procedure.
When an organ becomes available, the transplant coordinator will call you and direct you to the appropriate unit. You will have some basic testing completed and monitoring lines inserted. When the appropriate time comes, you will be taken to the operating room for the transplant.
A typical liver transplant lasts about five hours or more.
Patients are typically admitted to the Surgical ICU after surgery until the physicians feel that you can be transferred to a regular room. You will be monitored closely by the medical team and given transplant medications. We will provide you with extensive education about these medications and about how to care for your new liver.
Your length of stay in the hospital is determined by your health status before the transplant and the course of your recovery. Typically, transplant patients remain in the hospital for 10 to 14 days.
You will be visited daily by several members of the transplant team to assess your recovery, order any necessary testing, and educate you on the transplant process. Our physical therapists will work with you if needed to assist in your recovery. You will be allowed to resume a normal diet and move around the unit as determined by your doctors.
Following a liver transplant, you will initially require intensive hospital monitoring. The main focus will be on preventing organ rejection and infection while managing pain. While you are in the hospital, your care team will monitor your health and medications. Upon discharge, lifelong adherence to immunosuppressant medications is crucial, along with frequent follow-up appointments to monitor liver function and overall health. Lifestyle adjustments, including diet, exercise, and infection prevention, are essential for long-term success. While potential complications like rejection or infection exist, most patients experience a significantly improved quality of life and can return to many of their previous activities. AHN offers the emotional support resources to help you navigate the challenges of transplantation.
While transplant surgery is difficult, liver transplant life expectancy for the first year is 87% and the five-year survival rate is 73%. As surgeons and researchers develop more advanced transplant techniques, liver transplant life expectancy will increase.
Depending on your condition at the time of discharge, you may be admitted temporarily to a physical rehabilitation facility before going home. You may feel fatigued from the recovery and may have abdominal pain from your incision. We will monitor you for any side effects from the new medications and evaluate you regularly at the Transplant Institute.
While you are still in the hospital, we will tell you about changes you will need to make to your diet and lifestyle. When you are first released from the hospital, you will be required to have frequent blood work so your care team may adjust the levels of your medications and check the status of your liver. You will visit the Transplant Institute frequently at first upon release, and eventually you will only need yearly appointments.
You will have to strictly adhere to your new medication regimen. If you ever have any questions about your medication, our transplant coordinator will be readily available to you.
Transplant patients should be careful of infection and rejection of the transplanted liver. You will have to take medication to prevent rejection for the rest of your life. You should also take care to prevent infection. We recommend exceptional hand washing and avoiding others who are sick.
You will be allowed to return to work when your transplant physicians determine that you are able. Heavy lifting should be strictly avoided during the recovery period to reduce the risk of hernia.
Call 412-359-5017 or 412-359-6800 or request an appointment to learn more about AHN liver transplant services.
