Liver Transplant Evaluation and Assessment Guide

Glossary

Angiogram (Arteriogram)

Under radiology conditions, dye is injected into the blood vessels in order to determine if there are any blockages in the arteries.

Arterial blood gas (ABG)

A small needle takes blood from your wrist to measure the level of oxygen in your arterial blood. This can be a painful test.

Blood tests

A large number of blood tests are needed pre-transplant to monitor your liver function and check for other diseases. We also test for blood borne viruses,

for example, HIV, hepatitis B & C, blood group, tissue typing, to match your new liver, and cholesterol levels. Some of these special tests need to be repeated whilst you are on the waiting list.

Bone mineral density

This examination establishes a baseline of your bone density, assessing the strength of your bones. Thin bones, or osteoporosis is a common complication of liver disease and can be made worse by some of the drugs for example prednisolone that will be given to you after the liver transplant.

Bone scan

This scan is requested if you have a history of primary liver cancer and looks for spread of the cancer to your bones. An isotope will be injected 2 to 3 hours before the procedure. The scan takes about 40 minutes.

Chest X-ray

The chest x-ray is taken as a baseline image of your heart and lungs. You will have yearly chest x-rays whilst you are on the liver transplant waiting list.

Colonoscopy

This procedure allows the doctor to look at the inside of your large bowel or colon. This test is important to check for polyps and exclude bowel cancer. Polyps will be removed and biopsies may be collected.

Preparation – you will be told to follow a clear fluid diet 24hours before the procedure, and a special bowel preparation is drunk to ensure complete cleaning of the bowel. A sedative is given before the procedure. The colonoscope, a flexible tube with a miniature camera, is passed into the bottom then gently guided around the colon. The procedure takes about 40 minutes.

Cardiopulmonary exercise test (CPET)

The cardiopulmonary exercise test measures the response of the heart and lungs to exercise on a stationary bicycle. There is no pass or fail. Exercise capacity has a big influence on the need for support of the major body systems during and after an operation. The results of the exercise test guide the anaesthetist, surgeon and other doctors caring for the patient.

CT Scan

This X-ray is used to look at your liver, other organs and the blood vessels going to and from your liver. It is used to determine the size of the liver, presence of liver cancers and any other abnormalities. Some abnormalities of blood vessels may make transplant surgery more complicated or in some cases impossible to proceed with liver transplantation. Contrast dye is injected into your vein.

Echocardiogram

This is an ultrasound of your heart and assesses how well the different parts of your heart are working.

Electrocardiogram (ECG)

The electrical activity of the heart is recorded by placing electrodes over the chest, arms and legs. An ECG will identify any disturbances in the heart’s rhythm and helps detect underlying heart disease

Endoscopy

A flexible tube with a small camera is passed down your oesophagus, or food pipe into your stomach to determine if you have any enlarged veins called varices. Varices are a complication of liver disease. A sedative is given before the procedure. You need to fast for 6 hours before the procedure. The procedure takes about 15 minutes.

Endoscopy and Variceal Banding, or Gluing

Varices are large veins usually found in the oesophagus and/or stomach. Varices may rupture and cause major bleeding so that you need urgent treatment which is given at the time of endoscopy.

Banding of oesophageal varices involves placement of rubber bands over the varices at the time of endoscopy. Gluing is usually kept for stomach varices. Glue is injected into the stomach varices causing the blood in the varices to clot and eventually the treated varix will disappear. Sometimes it is not possible to know which treatment will be necessary until the time of endoscopy.

The variceal banding procedure is usually repeated every 2 to 3 weeks until the varices are treated or eradicated. It usually takes 3 to 4 treatment sessions.

Hepatology

The study of liver disease.

Hepatologist

A doctor who specialises in the care of the liver.

MRI (Magnetic Resonance Imagery)

Images of your body are produced through a combination of computers, a powerful magnet and radio waves. The images are similar to those of a CT scan. You will be asked to remove all metal objects before entering the

scanner, which is shaped like a cylinder. If you have any metal in your body from previous operations make sure you tell the doctor. It is important to remain very still throughout the whole procedure.

Pulmonary function test: Spirometry, respiratory function tests

These tests examine your breathing and lung capacity and give us a baseline recording of your lung function.

Swabs MRSA/VRE

Swabs are collected from inside your nose, groin and around your anus to test for micro- organisms resistant to antibiotics.

Ultrasound

A picture is created by reflected sound waves from an instrument that is moved across the skin. The doctors will be particularly interested in your liver, bile ducts and the blood vessels that supply blood to and from the liver.

24-hour urine collection

Urine is collected for 24-hours to test renal function. The urine will need to be collected in a bottle or pan and transferred into a special bottle.

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Last updated:: 25 November 2022

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