Evaluation Process

Once a liver transplant is considered to be a treatment option, a timely detailed evaluation of a child for transplant is a necessity. Your child's evaluation will :

  • Identify the risks and benefits of possible transplantation
  • Identify the need for and timing of transplantation
  • Identify technical (surgical) issues and appropriate donor sources
  • Establish a pre-transplant management plan
  • Provide a fully informative and frank family discussion to help prepare you and your child for the daunting but potentially life-saving road ahead

Our liver transplant coordinators will work with you and your family to lead your child through the evaluation process as smoothly as possible.

Before the evaluation begins, our team will work closely with you to collect key information including:

  • A comprehensive summary of your child's clinical records including representative radiographic studies and recent hospital discharges
  • A family evaluation report from a social worker
  • Insurance information (Insurance approval is mandatory prior to arranging an evaluation.)

Consultation and testing

The evaluation usually takes 3 to 4 days, which may be inpatient or outpatient based on your child’s medical condition. A detailed history, physical exam and tests are carried out in all cases. Tests include:

  • Blood tests to evaluate organ function, exposures and immunity to infection
  • Blood typing
  • EKG
  • ECHO
  • Chest x-ray
  • Abdominal ultrasound

Some children may require other special tests decided at the time, such as endoscopy, liver biopsy, etc.

You and your child will also meet with many transplant team members and specialists including:

  • The transplant program medical director and/or surgical director
  • Transplant nurse
  • Transplant nurse practitioner
  • Nutritionist
  • Social worker
  • Child life specialist
  • Neuropsychologist
  • Physical therapist
  • Other medical specialists on case by case basis, including an immunologist, gastroenterologist or cardiologist

Waiting process

After the evaluation, once your child has been approved for liver transplantation, the waiting period can take days or weeks, but averages about 2 to 3 months depending on the UNOS priority system for donor matching. It's not something we can predict, but we continuously strive to update your child's condition and develop an active management plan while your child is on the waiting list.

Our transplant coordinator must be able to locate you 24 hours a day, and you must be able to reach the hospital within 4 hours of the time that the donor liver becomes available. If you live further than 4 hours from the hospital, some insurance companies will cover the costs of Kangaroo Crew – Texas Children's pediatric transport program.