VI. Liver Transplant Recipients

A patient may not be considered as a recipient of a live donor adult liver if he or she is not an eligible candidate for a cadaveric liver transplant. The patient should meet the eligibility criteria set forth by the United Network for Organ Sharing (UNOS), must be listed on the cadaveric liver transplant waiting list, and must have suffered at least one significant complication related to his or her liver disease (e.g., variceal hemorrhage, spontaneous bacterial peritonitis, encephalopathy, or severe impairment to his or her quality of life due to fatigue, puritis, etc.). The UNOS recipient exclusion criteria for transplantation should be supplemented by the following exclusions for live donor adult liver transplantation (these exclusions may change as more data become available):

  1. a model for end-stage liver disease (MELD) score of greater than 25;
  2. adult fulminant hepatic failure;
  3. cholangiocarcinoma;
  4. hepatocellular carcinoma if:
    1. there is evidence of metastatic disease;
    2. comorbidities exist;
    3. the recipient can expect less than a one-year disease-free outcome.
  5. retransplantation for hepatitis C;
  6. need for dialysis;
  7. simultaneous combined liver/kidney transplantation (however, in cases involving hyperoxalosis or other specific metabolic disorders, special consideration should be given to allowing simultaneous liver/kidney transplantation from two different donors);
  8. acute alcoholic hepatitis.

The following information should be provided to the recipient:

  1. specific risks and benefits;
  2. alternative treatments available;
  3. expected outcome of transplantation.

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