Evaluation Process
Chronic illness can be very stressful for both the child and his family because it changes the family’s life style in many ways. Because transplantation adds further burden to the family, part of the transplant evaluation is to determine how the team can provide emotional support as well as the medical attention necessary for the child and the family. The evaluation period can be very time consuming, usually involving a few outpatient visits. If the child is acutely ill with liver disease, the process can be sped up. You will have many questions during the evaluation period. Feel free to discuss them with members of the transplant team
The transplant evaluation involves:
Review of medical and current immunization records
Your child will need a pneumococcal vaccination and a series of three Hepatitis B shots and two Hepatitis A shots if not already done.
Performance of blood tests, EKG, and x-rays
Blood tests for
- Tissue typing, which will be used by the United Network for Organ Sharing (UNOS) to find a donor that matches your child’s tissue and ABO typing to match your child’s blood type, which must be done on two separate occasions.
- Viral studies for CMV (cytomegalovirus), EBV (Epstein Barr virus), HSV (Herpes simplex virus), Hepatitis A, B and C, Varicella zoster (Chicken pox), HIV (human immunodeficiency virus)
Electrocardiogram
Chest x-ray to see if your child has an infection in his lungs
Duplex sonography scan
A noninvasive study used to assess the size and patency of the hepatic artery, a major blood vessel of the liver
CAT scan of the liver
Only if your child is undergoing a living donor transplant so we can see how well the portion of the donor liver matches the child’s whole liver
Meetings with members of the transplant team
Social Worker for a pre-transplant psychosocial evaluation. The social worker will gather family information, review financial information and discuss other family concerns as they relate to transplant preparation. Through this informational interview, your social worker can find out what your needs are and provide you with additional resources.
Financial coordinator to review and verify insurance coverage for transplantation. If you change jobs or your employer changes insurance carriers, contact the clinical nurse specialist or the social worker immediately.
Surgery or GI Nurse to discuss what you can expect in the early post-operative period and arrange a tour of the PICU (pediatric intensive care unit).
