Liver Transplant
Liver Transplant
What is a liver transplant?
A liver transplant is a type of surgery where a diseased or failing liver is replaced with a healthy one. Liver transplantation is one of a number of treatment options for patients with debilitating liver disease.
What conditions does a liver transplant treat?
Reasons patients may need a liver transplant include:
- Cirrhosis of the liver due to viruses, toxins and immunological diseases (end stage liver disease)
- Certain types of liver cancer (hepatocellular carcinoma and cholangiocarcinoma)
- Wilson disease (excess copper in the liver)
- Hemochromatosis (excess iron in the liver)
- Acute (sudden) liver failure
- Other rare metabolic and genetic disorders
Our Approach
The Liver Transplant Program at the U-M Health Transplant Center is part of the first and largest transplant programs in the state, the 15th largest in the country as well as one of the original transplant centers in the U.S. High volume, vast experience and a large team of physicians and surgeons means we have the capacity to take care of a large concentration of patients, especially patients who need to be hospitalized before their transplant.
Since our first liver transplant in 1985, we have completed over 3,000 liver transplants, performing approximately 100+ transplants a year. Our patient survival rate at one year is 91%, and our graft transplant survival rate is 89%, both on par with national survival statistics. We are highly experienced with splitting livers (allowing for a greater amount of transplants to occur), which involves portioning the donor liver, and using the smaller portion to transplant a child and the larger portion to transplant an adult.
About 7-10% of our adult patients receive a partial graft, which is above the national average. At our Pediatric Liver Transplant Program, also one of the largest in the country, we perform 15-20 liver transplants a year and at least half of those are split graft transplants. We also have a comprehensive transition program for our pediatric patients who are old enough to move into our adult program.
We also perform Living Donor Liver Transplant.
View our U-M Health Transplant Center: Liver Transplantation playlist
Liver Transplant for Complicated Cases
U-M Health is one of only 20 programs in the country that offers liver transplant for hilar cholangiocarcinoma (bile duct cancer) approved by United National Organ Sharing, which involves complicated multi-modality therapy before the transplant. We have the expertise required in multiple disciplines (i.e. radiation oncology, medical oncology, interventional radiology, surgery, and hepatology) to administer this type of therapy. We also utilize a multi-disciplinary team to treat and downsize patients with advanced hepatocellular carcinoma (primary liver cancer) using state of the art locoregional therapy including chemoembolization, radiofrequency ablation and radiation therapy.
Appointment Information
To make an appointment to evaluate your need within our Transplant Center, call a patient care representative at 1-800-333-9013.
About the Transplant Center
The opportunity for a new life occurs every day at the University of Michigan Health Transplant Center. And since 1964, more than 13,000 patients have benefited from our devotion to the individual.
What To Expect
Here's what to expect with a liver transplant.
Candidates for a liver transplant require a comprehensive evaluation. The process includes patient education, medical records review, and patient examination. The patient meets with several members of the transplant team, including a transplant coordinator, hepatologist, surgeon, social worker, and nurse educator. The evaluation appointment involves various tests, such as blood tests, chest x-ray, urinalysis, drug screening, and Alpha Fetoprotein (to check for liver cancer). The case is reviewed by our multidisciplinary transplant team, and a decision about the patient’s suitability for an organ is made.
Each member of the multidisciplinary team at the Transplant Center is a specialized expert dedicated to transplant patients, including subspecialist radiologists. We have the largest concentration of liver MRI radiologists in the region—experts who only read MRIs. We also maintain the latest equipment for the best possible imaging.
Our dedicated transplant coordinators are the first contact for patients. Each patient is assigned a specific coordinator who will be your point person for anything regarding your care, from pre- to post-transplant. Their responsibilities include answering questions, completing everything needed for you to be listed, ensuring periodic testing is scheduled, helping with medications, and alerting your medical team if you are undergoing treatment for other health issues.
One of our greatest priorities is to provide education and support to our patients and their supporters before and after transplant. We provide a Patient Education Guide and offer a weekly support group where patients and families can learn more about the process and engage with others. We also offer peer mentoring by former liver transplant recipients. For patients living outside the area, we connect them with local transplant recipients for peer mentoring. Family members have several housing options while in Ann Arbor for the operation and hospitalizations, including the Med Inn hotel located on the medical campus.
Once you’ve been listed, our team provides ongoing medical care to ensure you are as healthy as possible for your transplant. This care includes testing as needed, treatment for health issues, and communication with your local hepatologist. Each patient is assigned a hepatologist from the start of the process and throughout their care to ensure continuity.
If the transplant team determines you aren’t ready to be listed, it may be due to your health or liver disease that can be treated. Our goal is to optimize your condition so you qualify for listing and have better outcomes after transplant. This may involve improving nutrition, increasing activity levels, stopping smoking, and optimizing medical care.
The transplant center offers treatments to delay the need for a liver transplant or prolong life while waiting for a donor liver. These include:
- Medications for liver diseases such as hepatitis B and C and autoimmune disorders.
- Treatments for liver tumors to make transplantation possible.
- Bioartificial liver devices to support patients with acute liver failure.
- Transjugular intrahepatic portosystemic shunt (TIPS) for patients with cirrhosis to manage fluid buildup or gastrointestinal bleeding.
When a donor liver becomes available, the patient is admitted to the hospital. The operation typically lasts six hours, during which the recipient’s liver and gallbladder are removed, and the donor liver is transplanted. Post-surgery, patients spend about four days in the ICU and 10 days on the transplant floor.
After a liver transplant, patients are seen frequently during the first three months. An individualized care plan is developed, and eventually, patients transition back to their local hepatologist’s care. Periodic visits to the University Hospital’s transplant clinic are required, typically reducing over time to once or twice per year. Physical therapy and visiting nurse services may also support recovery.
Research
Research is an important component of the transplant center, where we are committed to cutting-edge studies that will benefit today's patient and patients of the future. The Liver Transplant Program has active research studies in a variety of areas, including early detection of liver cancer, adverse outcomes of frail patients post-transplant – and creating frailty measurements for improving physical function prior to transplant, acute liver failure studies, protocols for patients with Hepatitis B and Hepatitis C infection both before and after liver transplant, and a variety of immunosuppressive and antibiotic studies and protocols.
In the next year, we will be involved in studies using room temperature pumping and conditioning of livers prior to implantation which may improve patient and graft survival. Our comprehensive multidisciplinary clinics and extensive clinical and basic science research programs assure our patients have access to the newest medications and technologies.
Patient Resources
Locations
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Gastroenterology Clinic | Taubman Center 1500 E Medical Center Dr
Floor 3 Reception D
Ann Arbor, MI 48109-2435Get Directions -
Hepatology Clinic | Brighton Center for Specialty Care 7500 Challis Rd
Entrance 1, Level 2
Brighton, MI 48116-9416Get Directions -
Hepatology Clinic | Northville Health Center 39901 Traditions Dr
Floor 2
Northville, MI 48168-9493Get Directions -
Liver Transplant Evaluation Clinic | Trinity Health Wege Medical Center 300 Lafayette Ave SE
Grand Rapids, MI 49503Get Directions -
Transplant Clinic | Taubman Center 1500 E Medical Center Dr
Floor 1 Reception G
Ann Arbor, MI 48109-5334Get Directions
Doctors
Frederick K Askari, MD, PhD
Clinical Associate Professor
Gastroenterology, Internal Medicine, Clinical Molecular Genetics
Meredith Barrett, MD
Clinical Assistant Professor
Surgery
Ben Edwin Biesterveld, MD
Clinical Assistant Professor
Transplant Surgery, Surgery
Hari Sree Conjeevaram, MD, MSc
Professor
Gastroenterology, Internal Medicine
Michael Joseph Englesbe, MD
Professor
Surgery
Robert John Fontana, MD
Professor
Gastroenterology, Internal Medicine, Transplant Hepatology
Ammar Zahid Hassan, MBBS
Adjunct Clinical Assistant Professor
Gastroenterology, Internal Medicine, Transplant Hepatology
Hellan Kang Kwon, MD
Clinical Associate Professor
Gastroenterology, Internal Medicine, Transplant Hepatology
Alisa Likhitsup, MD, MPH
Clinical Assistant Professor
Gastroenterology, Internal Medicine, Transplant Hepatology
Nikhilesh Ray Mazumder, MD, MPH
Assistant Professor
Transplant Hepatology, Gastroenterology, Internal Medicine
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