Pre-Transplant Evaluation

The pre-transplant evaluation process determines whether your child needs a liver transplant. During your child's evaluation, the team at Seattle Children's Hospital will help you and your family to learn more about transplant. You will learn about:

  • Benefits and risks of transplant
  • Medicines that suppress the immune system
  • Health insurance coverage
  • Organ donation
  • What to expect while waiting for an organ
  • What to expect during surgery
  • What to expect after surgery

This evaluation is usually done on an outpatient basis. It may take several days to complete the entire process, depending on the medical urgency of your child's case.

What happens during the pre-transplant evaluation?

The evaluation begins with a review of your child's medical and surgical history. You will then have an office visit with a hepatologist - a doctor who specializes in liver diseases.

You will meet with a transplant surgeon, who will explain the transplantation operation and discuss any specific aspects of your child's transplant evaluation that may affect the surgery or that may be particularly concerning to the team.

In addition, your child may see other specialists, depending on your child's condition.

You will also meet other members of the transplant team, such as the anesthesiologist, transplant nurse coordinator, nurse practitioner, transplant specialist, dietitian, pharmacist and social worker.

The team will explain the surgery, donor options and the type of care your child will need after the transplantation.

Your child's nurse coordinator will organize your child's evaluation. This includes coordinating the tests and consultations needed for a complete evaluation.

Your child's social worker will help your family and child understand the emotional and practical aspects of transplant and help you address your child's social and emotional needs.

Your transplant specialist will schedule your child's clinic appointments and help you understand the details of your insurance coverage that relate to transplant. If needed, the specialist and social worker will work together with you to identify sources of additional funding.

The pharmacist will help explain the medications your child will need after transplantation.

The dietitian will tell you how food and diet can help your child before a transplant and how your child's nutritional needs will change after transplant.

What tests are needed?

Many tests are needed for the pre-transplant evaluation. These tests help us to:

  • Decide how urgently your child needs a transplant
  • Ensure that your child receives a donor organ that is a good match

Types of testing and interviews include:

  • Blood and lab tests
  • Diagnostic tests
  • Social work evaluation
  • Nutritional assessment
  • Financial assessment

The transplant team will determine whether your child needs any additional tests.

Please note that we consider each child on an individual basis and that we may request other consultations in order for us to understand your child as completely as possible.

What about evaluation of a living donor?

If a living-donor liver transplant is being considered, the person who volunteered to donate will have a separate evaluation at University of Washington Medical Center. This happens after:

  • You and the liver transplant care team decide your child is a candidate for liver transplantation.
  • Your child has been placed on the United Network for Organ Sharing (UNOS) transplant waiting list.