Evaluation, Education and Consent
Step 1: Evaluation by Hepatologist
The first step is to be referred to one of the Jefferson
hepatologists (liver specialists). A hepatologist reviews each patient's
medical history and previous diagnostic tests and procedures and then
examines and interviews the patient. From there, the hepatologist will
determine if there are any alternative treatments for the patient and,
if not, if the timing is right to refer the patient for a transplant
Step 2: Preapproval for Transplant Evaluation
There are several steps that must be completed before a patient
can be evaluated by Jefferson's Liver Transplant Program. First, the
patient's referring physician(s) sends medical information to the
transplant office. Meanwhile, the Liver Transplant Program's financial
coordinator contacts the patient's payer(s) to ensure Jefferson has the
necessary authorizations before the evaluation.
Once the financial coordinator has obtained the necessary
authorization, a Liver Transplant Program social worker (a professional who evaluates readiness for
transplantation and helps support your psychosocial needs) reaches out to
the patient to set up the first appointment.
Step 3: Education and Consent for Transplant Evaluation
Patients should plan to spend about half a day for the education
and consent process. At this appointment, patients meet with a variety
of professionals from the Liver Transplant Program and spend an hour
with a social worker.
That session is followed by a two-hour education and consent
session with a transplant coordinator (a nurse who serves as the
patient's point of contact throughout the process). During this session,
patients receive a thorough overview of liver disease, as well as an
overview of Jefferson's Program and personnel.
The transplant coordinator also reviews the in-depth Consent for
Evaluation for Liver Transplant, which patients must understand and sign
before they can proceed with a transplant evaluation.
Finally, the transplant coordinator outlines the medical tests
and consultations that must be performed as part of the evaluation
Step 4: Evaluation for Liver Transplant
After completion of the first three steps, a pretransplant
coordinator will reach out to the patient to introduce him- or herself
and to reiterate the tests and consultations that must be completed as
part of the transplant evaluation process. Each patient's requirements
vary depending on his or her condition and/or circumstances. The testing
and consultations typically take two or three days to complete.
Toward the end of the transplant evaluation process, the patient
views a presentation about the Model for End-Stage Liver Disease (MELD)
system, as well as the process for listing patients and allocating
organs in our region and across the United States.
Once all of the testing and consultations are complete, the Liver
Transplant Program's multidisciplinary committee reviews the patient's
case to determine that no other treatment options are available and that
the patient has no contraindications (such as heart disease or lung
disease). Following that review and approval, the patient is listed for a