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The pretransplant evaluation starts as soon as a potential transplant would represent a genuine benefit. This condition is met when the patient has end-stage liver disease in which the predicted life expectancy of life would clearly be greater with this procedure. The hepatologist will decide when it is time to start the pretransplant evaluation.
This consists of a series of diagnostic tests that help determine whether a patient would be a good candidate and rule out the presence of any contraindications against the procedure. After the tests, the doctor in charge will present the case to the Transplant Committee.
Presentation to the Transplant Committee
Transplant Committees are formed by representatives of the different health professionals who participate in liver transplants (anaesthetists, surgeons and hepatologists). This group of doctors will decide whether liver transplant candidates should be accepted or rejected. The accepted patients are then admitted to the waiting list.
Admission to the liver transplant waiting list
Patients are included in a waiting list that depends on the OCATT and the ONT. Patients are admitted to the waiting list in function of their MELD score. The MELD system classifies patients according to the severity of their liver disease, that is, the most seriously ill patient is first on the list. The system uses a formula to calculate a score based on blood test parameters measured while on the waiting list (creatinine, bilirubin and clotting, INR). The MELD score ranges from 6 to 40 (lowest to highest severity).