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Preparing for the Transplant | Liver

Pretransplant tests, in addition to giving a clear picture of your overall health, help identify issues that may need to be addressed before or after transplantation. They also help determine whether transplantation is your best option. This increases the likelihood of success.

The following tests help evaluate the health status of your liver and related structures:

• Liver function tests — Blood tests are used to monitor liver function (e.g. albumin); damage to liver cells (e.g., alanine transaminase [ALT], Aspartate transaminase [AST]) and some with conditions linked to the path by which bile is produced by the liver (e.g., gamma-glutamyl transferase and alkaline phosphatase).
• Radiology tests – Special scans of your abdomen are required to assess the liver and other organs for conditions such as tumors and abnormalities in the blood supply to the liver.
• Hemodynamic monitoring — A cardiac echo is required to check for high blood pressure in your heart and lungs; a more detailed examination involving the placing of a catheter within the heart may be necessary.
• Liver biopsy — Evaluates a little piece of tissue from your liver.

General pretransplant medical tests include:

Physical exam Chest x-ray Complete medical and surgical history Blood tests – These tests include blood count, blood and tissue type, blood chemistries, and immune system function. Your blood will also be checked for certain infectious diseases Blood typing – Every person is a blood type A, B, AB or O. Your blood will be checked to determine if it is compatible with the recipient Pulmonary function test — These tests show how well you lungs are working Upper and lower gastrointestinal (GI) endoscopies – These evaluations can detect abnormalities of your esophagus, stomach, and colon Tissue typing – Your white blood cells will be tested for special "markers" that distinguish "tissue type" needed to match the transplanted organ Renal function studies — Your doctor may ask you to collect your urine (usually for 24 hours) to evaluate if your kidneys are working properly. Blood tests such as serum creatinine are performed to measure kidney function

Panel Reactive Antibody (PRA) — This is one way of measuring the activity of your immune system (higher PRA means your are making more antibodies) Viral testing — Blood tests will reveal if you have been exposed to viruses such as hepatitis, Epstein-Barr (EBV), cytomegalovirus (CMV), or human immunodeficiency virus (HIV) Electrocardiogram (EKG or ECG) — Asseses the electrical activity within your heart Echocardiogram — Sonar-type echos can show abnormalities in the heart and lungs Tests for osteoporosis — Screening for osteoporosis may be ordered by DEXA scan or other means Mammogram — Breast x-rays to look for signs of breast cancer in women Prostate-specific antigen (PSA) and prostate exams — To screen for prostate cancer in men Dental Examinations Other tests — Your doctor may order other tests as well

References
Carithers. Liver Transpl 2000;6:122-35