This overview is meant to give you general information regarding the living donor liver transplant work-up process at The Johns Hopkins Hospital. This work-up is done in a step-by-step process enabling the transplant team to review the results from each step before proceeding to the next. This process was developed to prevent unnecessary testing. When you meet with the transplant surgeon and hepatologist (a medical doctor specializing in diseases of the liver), you will be given detailed information on the surgery, the risks and the recovery period. It is our priority to protect you as the donor from any potential harm now or in the future relating to your donation.
Please note this is an outline only, and not to be used as a written physician order.
- Step 1: Initial Call about Living Donation
- Step 2: Screen Tests
- Step 3: Evaluation Appointments
- Step 4: Scheduling the Donor Surgery
Step 1: Initial Call about Living Donation
People who are interested in becoming a living donor must first make contact with the living donor nurse coordinator. This individual will help answer any questions or concerns you may have regarding the process. Should you wish to proceed, you will be directed to work with the living donation patient services coordinator to collect your basic demographic information and send you forms that need to be completed in order to start the screening process. When you return these forms, the donor team will contact you to discuss your next steps.
Step 2: Screening Tests
Once the potential donor has completed the initial paper work and has been deemed a potential candidate, the donor will need to volunteer to proceed with the medical screening. This information is not provided to the recipient. It is completely up to the donor as to whether or not they wish to proceed. The following documents will need to be obtained from the potential donor in order to continue on in the process.
Tests may include but are not limited to:
- History and physical exam from primary care provider
- Recent lab work and diagnostic tests
- Mammogram (for women over age 40)
- Pap smear
- Colonoscopy (if over age 50)
Upon receipt of the information listed above, the potential donor’s chart will be reviewed by the living donor nurse coordinator. If the individual is still deemed a potential donor, they will then be scheduled for an evaluation appointment. If an individual is deemed not a candidate for donation, they will be notified by the living donation nurse coordinator.
Step 3: Evaluation Appointments
If problems are not discovered during the initial screening, a two-day donor evaluation appointment will be scheduled. We encourage you to bring a family member to meet with your living donor team; this should be your significant other or the person who will most likely be helping you during your surgical recovery.
This two-day evaluation appointment will include meeting with the donor team as well as lab work and diagnostic testing.
Below is a list of the donor evaluation team, as well as a listing of required lab work and diagnostic testing.
- Psychologist/donor nurse coordinator
- Social worker
Day one will consist of lab work and diagnostic testing as well as meeting with the living donation nurse coordinator.
- Lab work
- CT scan of the abdomen/pelvis with contrast
- Chest X-ray
- Cardiac testing
- Consultation with living donation nurse coordinator
Day two will consist of meeting one-on-one with various members of the living donation team.
- Living donor advocate
Within one week. Additional testing may be required by our transplant team upon completion of the evaluation.
Once all required tests are completed our transplant team will meet to discuss the results and clear the donor for surgery. A surgery date will then be scheduled when both the recipient and donor are cleared and ready.
Step 4: Scheduling the Donor Surgery
Additional testing may be required once the results of your one-day donor evaluation are complete. Once all testing is complete, the donor’s case will be presented to a multidisciplinary committee. This committee will decide if the donor is indeed a good candidate for transplantation. It is important to know that donors may be excluded at any point during the donor evaluation process. If you still wish to proceed, upon completion of testing and approval from the committee, a surgical date will be set in preparation for the transplant. In most circumstances, the transplant is scheduled four to six weeks in advance. This allows you to arrange time away from work, child care, school schedules and other daily responsibilities.