Don’t get you hopes up too soon You may be surprised at how slow the process goes. He probably already submitted a lengthy application. If not, he should be prepared to provide his family medical history, his own medical history, and hospitalizations or surgeries he’s had, shot record, whether or not he’s had any of the typical childhood illnesses (chicken pox, mumps) as well as any other diseases he’s ever had. Names and addresses of all of his doctors, prescriptions he is currently taking, insurance coverage, current conditions and dates of diagnosis/procedures. He’ll need to provide a history of ESLD symptoms, date of onset, treatments, etc.
He will probably meet with a hepatologist for a consultation on the first visit. Then they will probably want to do blood work. My husband went to Shand’s hospital for almost 6 years and only got recommended for transplant evaluation (this is recommended by the hepatologist) twice in the last year and a half we went there.
If he were having an evaluation, they would send out a schedule of tests and meetings that cover 2-3 days.
During the evaluation, meetings would be set up with:
o Transplant Coordinator – To discuss the evaluation process through to the transplant procedure as well as financial considerations to include fundraising. They will also want to determine who is his support system to include caregivers and anyone providing transportation as well as backup caregivers in event something happens to the primary.
o Financial Services – To discuss transplant costs and how he intends to pay—insurance, copays, etc.
o Pharmacy Services – To discuss maintenance drug costs, insurance coverage, copays, etc.
o Social Worker – To discuss his history—drug use, alcohol, marital status, mental state, family history, etc.
o Transplant Surgeon – To discuss their opinion and answer any surgical questions
The tests involved in the evaluation include:
o Cardiac Stress Test
o Abdominal Ultrasound
o ABG (special blood draw to measure gas levels) taken from the wrist
o Chest Xray
o Lab Draws
Each case is different, so there may be additional tests schedule.
There are vaccinations that must be up to date in order to proceed with transplant. These were required to be up-to-date for my husband:
o PPD [TB skin test]
o Flu Vaccine (Annually)
o Pneumovax (every 7 years)
o Tetanus (every 10 years)
o Double Dose Hepatitis B Series (only after shown negative for the HepB surface antibody)
o He should also have a recent Endoscopy and Colonoscopy
o Some centers require a recent liver biopsy
I hope this information gives you an idea of how complex the process is. If and when he is scheduled for an evaluation, I encourage you to see that as many family members attend as possible. This show of force can make all the difference in their decision to proceed.
Good luck and my God bless you.