Liver Referral Criteria & Process

Refer your patient with liver disease to University Health’s transplant program for compassionate, advanced evaluation and treatment.

Reasons for a Liver Transplant Referral

You may recommend a patient for a liver transplant evaluation if he or she has one or more of the following liver conditions:

• Acute liver failure from viral hepatitis or drug toxicity
• Alcoholic cirrhosis – Patients with alcoholic cirrhosis are considered for transplant if they can achieve abstinence and rehabilitation
• Cholestatic diseases such as primary biliary cholangitis, primary sclerosing cholangitis, secondary biliary cirrhosis and cystic fibrosis
• Chronic hepatitis, hepatitis B, hepatitis C, hepatitis D, autoimmune chronic active hepatitis, cryptogenic cirrhosis, chronic drug toxicity or toxin exposure
• Chronic liver disease limiting your patient’s quality of life and ability to work
• Irreversible liver disease with no effective treatment alternatives
• Metabolic diseases such as hemochromatosis, Wilson's disease, Alpha-1-antitrypsin deficiency, glycogen storage disease, tyrosinemia, familial amyloidotic polyneuropathy, other metabolic disorders treatable by liver replacement
• Predictable mortality from liver disease exceeding transplantation prognosis (85% one-year survival, 70% five-year survival)
• Primary liver tumors – Select patients with hepatocellular carcinoma (HCC)

Liver Transplant Eligibility

Consider whether your patient meets our referral criteria for a liver transplant evaluation.

Reasons Not to Refer for a Liver Transplant

We will not consider your patient as a liver transplant candidate if he or she has:

• Active drug or alcohol use
• Patient history indicating other end-stage medical conditions
• Metastatic cancer

Behavioral Assessment Requirement

Count on us to perform a required psychiatric assessment of a patient who does not meet alcohol or drug abstinence requirements in the initial evaluation.

Re-evaluation

If your patient does not meet the referral criteria, he or she may return for re-evaluation at a later date.

Three-Step Liver Transplant Referral Process

When your patient meets all the referral criteria, follow our three-step referral process for adult liver transplantation:

• Complete the online Liver Transplant Referral Form OR
  Download and print the Liver Transplant Referral Form [PDF, 90 KB] OR 
  Pediatric Liver Transplant Referral Form [PDF, 124 KB]
  
  Submit the completed referral form and a copy of the patient’s insurance card (front and back) to University Health Transplant Institute using one of the following methods:

• Download and print the Liver Referral Patient Information Cover Sheet & Checklist [PDF, 33 KB].
  
  Complete the cover sheet and include all patient information on the checklist. Submit the information to University Health Transplant Institute by fax or mail.

• Within 24 hours of receiving your patient referral, we will contact your office by phone and/or email to:
  • Confirm receipt of your referral
  • Confirm receipt of all patient information
  • Notify you and your patient of the initial evaluation date
  • Answer your questions and provide support

Advanced Liver Treatments

Find advanced medical and surgical liver care and treatments at University Health for conditions that may prevent transplantation. Call 210-567-5777 or 1-888-336-9633 to talk to one of our transplant physicians or coordinators.