Once your insurance has approved your transplant, you will be placed on the transplant waiting list. You will receive:

• A letter stating that your name has been added to the list.
• A doctor’s order showing what lab tests you will need at your local clinic. Bring this to the clinic. The order will state how often you need lab tests and where the clinic should send your results.

What is my MELD score and how does it affect my time on the waiting list?
MELD stands for Model for End-Stage Liver Disease. The MELD score uses a complex formula that includes specific blood values for total bilirubin, INR and creatinine.

Your MELD score is based on your lab results. Adult scores range from 6 to 40. The patient with the highest score receives the next liver available for his or her blood type. The higher your score, the more often you will need lab tests. Your doctor or transplant coordinator will tell you what your MELD score is at each clinic visit.

Your lab results must be sent to the transplant office on time. (See below.) Make sure your clinic sends the results on time, or call your transplant coordinator after each lab test. If you do not, you may fall to a very low MELD score. This means your transplant could be delayed. If you have questions, please talk to your coordinator.

Your MELD score will change over time. A member of your transplant team will tell you how often you need lab tests.

• If your MELD score is 25 or greater: You will need new lab tests every week. Fax your results within 48 hours. If we receive tests that are more than seven days old, you must repeat the tests. 
• If your MELD score is 19 to 24: You will need new lab tests every month. Fax your results within seven days. If we receive tests that are more than one month old, you must repeat the tests. 
• If your MELD score is 11 to 18: You will need new lab tests every three months. Fax your results within 14 days. If we receive tests that are more than three months old, you must repeat the tests. 
• If your MELD score is 10 or less: You will need new lab tests every year. Fax your results within 30 days. If we receive tests that are more than 12 months old, you must repeat the tests.

Your donor
Your new liver will be “matched” according to size and blood type. Usually, a liver is chosen from a donor who has the same blood type as the recipient. The new liver must fit into the body in about the same position as the original liver: the upper side of
the abdomen, under the ribs. The blood vessels leading to and from the liver can
be more easily connected if they are about the same size as those of the old liver.
There are three types of donors: deceased donors, expanded criteria donors and living donors.

Deceased donors
A deceased donor is someone whose tissues or organs are donated soon after he or she dies. Some of these donors have livers that are large enough to split between two people. Split livers are used only in smaller recipients. If this is an option for you, the surgeon will tell you during your evaluation.

The donor’s health history may affect the success of your transplant. If the organ is damaged before we receive it, this may affect your outcome as well. There is a small risk of getting a disease from a deceased donor (such as HIV or hepatitis). All donors are tested for disease, but some diseases may not show up at the time of testing.

Expanded criteria donors
These are deceased donors who may be older than standard donors or have had certain health problems. They are not perfect donors for everyone, but they may be a good fit for some people. Please tell your surgeon if you would like to learn more
about this option.

Living donors
The wait time for a deceased donor liver can be very long. At the University of Minnesota Medical Center, it is possible to use a live donor. A living donor transplant involves taking part of the liver from a family member or friend and using it for transplant. We can do this because the liver is one of the few organs that can regenerate (grow back).

A living donor may help you avoid a long wait for your new liver. The donor must undergo a major surgery that involves some risk. The donor must be in good health to qualify. A living donor is often a friend or family member. If someone you know is interested in being a living donor, he or she can contact the transplant office after your evaluation is completed. A donor needs to have a medical and psychological evaluation. If you are very ill, a living donor may not be an option for you.

Click here to learn more about our Living Liver Donor Program.