We performed the first liver transplant in Ohio in 1985 and have since performed more than 700 liver transplants.

Why choose Ohio State?

Expertise: 
We are experts in treating hepatocellular carcinoma and in preparing these patients for liver transplantation. We are one of only 41 comprehensive cancer centers in the nation, as designated by the National Cancer Institute. In collaboration with the OSUCCC – James, our team of surgical oncologists, interventional radiologists, transplant surgeons, transplant hepatologists and medical oncologists offers unparalleled care for this disease.

Experience:
Our Comprehensive Transplant Center has one of the largest organ transplant programs in the nation. We perform nearly 250 kidney, liver, pancreas, combined kidney/pancreas, heart, lung and bone marrow transplants each year. Since our program started in 1967, we have performed more than 7,700 lifesaving transplants.

Research:
We are a member of the Acute Liver Failure Study Group, a collaborative network of 28 hospitals that have studied more than 2,000 cases of acute liver failure. Current trials include phase II and phase III investigations of medications to treat hepatitis C; new treatment approaches for treating decompensated liver disease; and emerging therapeutic options for both hepatocellular carcinoma and cholangiocarcinoma.

Candidates

Candidates

Candidates

Many diseases and conditions may cause liver damage or failure:

  • Nonalcoholic Steatohepatitis (NASH): a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. 
  • Hepatitis: Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Hepatitis is an inflammation of the liver. 
    • Hepatitis C Virus is caused by the hepatitis C virus (HCV). It usually spreads through contact with infected blood. It can also spread through sex with an infected person and from mother to baby during childbirth. There is no vaccine for HCV.
    • Hepatitis B Virus is caused by the hepatitis B virus (HBV). Hepatitis B spreads by contact with an infected person's blood, semen, or other body fluid. An infected woman can give hepatitis B to her baby at birth.
  • Alcohol
  • Autoimmune Liver Diseases: Autoimmune liver diseases include a family of inflammatory conditions in which the body's immune system attacks the liver or bile ducts.
  • Hereditary Liver Diseases: The two most common inherited liver diseases are hemochromatosis and alpha-1 anti-trypsin deficiency.
    • Hemochromatosis is a disease in which the body absorps too much iron. This iron is deposited in the liver, causing progressive scarring of the liver. The primary form of this disease is the most common inherited disease in the U.S. When one family member has this disorder, siblings, parents and children are also at risk.
    • Alpha-1 Anti-Trypsin Deficiency is an inherited liver disease in which an important protein known as alpha-1 anti-trypsin is not manufactured correctly by the liver, and is not able to be released into the blood stream. The protein accumulates in the liver, causing progressive scarring of the liver. It also leads to low levels of the protein in the blood stream, and can often cause lung disease as well.
These conditions may destroy healthy liver cells and result in cirrhosis (scarring of the liver). When medical treatment is not effective for keeping a liver functioning, a transplant may be the only treatment. 

Your overall health, not your age, is the most important factor in determining if you are a suitable organ recipient. Screenings before transplant ensure that you are in good medical and psychological health and that you have the motivation and support to comply with treatment plans. All patients must meet the chemical dependency requirements of the Ohio Solid Organ Transplantation Consortium. People who have cancer in other areas of the body; serious heart, lung or nerve disease; active drug or illegal drug abuse; or active serious infection may be ruled out as transplant candidates.

Patient Process

Patient Process

Patient Process

A goal of our Comprehensive Transplant Center is to ensure our transplant patients experience a thorough continuity of services through the entire transplant process, including pre-transplant evaluation, communication throughout the waiting process, acute medical care during and following surgery, intensive outpatient treatment, post-transplant outpatient visits and ongoing telephone follow-up.

Referral Phase

If you would like additional information about liver transplantation, please ask your doctor to contact the Liver Transplant Program at Ohio State at 614-293-6255.

After your doctor has made a referral for you, you will be contacted by our office for an appointment to see a member of our Transplant Hepatology team. After that initial visit, the decision may be made to refer you for evaluation for our liver transplant list.

Our team here at Ohio State will then help you with verification of insurance benefits. Liver transplant is not always covered by insurance. Once your insurance company has given the approval for a liver transplant evaluation, we then schedule the necessary testing.

Pre-Testing Phase

Testing is performed to help our doctors determine if liver transplant is needed and if it’s the best choice of treatment. Our goal is to schedule the majority of the pre-transplant testing during a one-day visit. This testing may include lab work, imaging and heart and lung testing. It is strongly preferred that these tests be completed at Ohio State’s Wexner Medical Center.

You will be asked to have a dental evaluation. Females will be required to have a mammogram and Pap smear if they have not been done within the past year.

Imaging tests we will perform:
  • Magnetic resonance imaging (MRI) or computerized tomography (CT scan): This provides detailed pictures of the organs and structures inside your body.

  • Chest X-Ray: This provides a black and white picture of your lungs, heart, ribs and diaphragm.

Cardiac tests we will perform:

  • Electrocardiogram (EKG or ECG): This is a record of your heart’s electrical activity, including heart rate. It is used to identify heart disease.

  • Echocardiogram: This shows how well your heart is pumping, examines the heart valves and estimates the blood pressure in different parts of the heart. Results provide insight into whether your heart can withstand a liver transplant, or if additional testing is required.

  • Nuclear myocardial stress test: A stress test is a specific type of ECG that compares the heart’s electrical activity at rest and under exertion. Medication is given to stress the heart and determine if it has a healthy blood supply. If you meet criteria for a cardiology referral then the stress test will not be ordered.

  • Cardiology referral: This may be ordered based upon your medical history, age or family history. This provides a detailed report of the heart valves, pressures and arteries and allows doctors to know if you have coronary artery disease that can cause blockage that can limit good blood flow. During this visit, the cardiologist will determine if a heart catheterization needs performed at a later date.

Pulmonary tests we will perform:

  • Pulmonary function test: A deep breathing into a machine that monitors lung volume. This measures how well your lungs work when you breathe in and out.

  • Six-minute walk: A walking test that measures exercise impairment and oxygenation. This will determine if you oxygen level is adequate to support a new liver.

  • Arterial Blood Gases: A blood draw that measures the acidity (pH), oxygen and carbon dioxide in the arterial blood. This will see how well the lungs are able to move oxygen into the blood and carbon dioxide from the blood.

Lab tests we will perform include:
  • Blood test: to check liver function. This will be done after your office visits and as needed to monitor your condition.

Scope procedures we will perform:

  • Endoscopy: A procedure that will diagnose and treat enlarged veins, inflammation or ulcers in the stomach that can be caused by advanced liver disease. You will receive intravenous medication that will allow the physician to insert a flexible scope through your mouth, esophagus, stomach and upper small intestine.

  • Colonoscopy: A procedure to diagnose and treat bleeding, polyp growths and screen for cancer. A cleansing prep will be taken the day before testing scheduled to eliminate waste from the colon. You will receive intravenous medication for the physician to view the entire colon with a flexible scope.

Clinic Evaluation Phase

After testing is completed, you will take part in an evaluation and education program at our Comprehensive Transplant Center. You will meet the pre-transplant coordinator, surgeon and social worker. We will answer your questions about liver transplant surgery.

During this evaluation, we will detail the surgery, medications, recovery and rehabilitation associated with the transplant process. The main focus is on educating you and your family.

Every patient will receive a physical examination. You will be asked detailed questions about your medical history, prior surgeries and medications. It is best to attend with a thorough list.

Every patient being evaluated for liver transplantation will have a psychosocial assessment with a social worker to determine if you have the psychological stability, motivation and personal support to meet the challenges of transplantation. Before the appointment, you will complete a psychosocial survey that will be reviewed during the evaluation. You may be referred to see a transplant psychologist for further assessment.

Candidacy Phase

If it is determined that you are an appropriate candidate for liver transplantation, you will be listed for a liver transplant with United Network for Organ Sharing (UNOS).

A letter is sent to your insurance company providing recommendations for transplantation and requesting approval for transplant surgery, medications and follow-up care. Once approval is given, you are then listed for liver transplantation on the UNOS national waiting list. A letter will be sent to you detailing your responsibilities while waiting for your transplant.

If deferred or denied listing for a liver transplant at our facility, a letter will be mailed to your home specifying the reasons why you were not listed for transplant. However, this may include criteria requirements that need to be completed prior to listing.

Active Wait List Phase

Please be prepared to wait as long as several months for your liver transplant. The donor must have a blood type compatible with yours and be similar in body weight and size to you. Each potential donor also must be screened very carefully for disease, infection or trauma to ensure that you receive a healthy liver.

The process for prioritizing candidates waiting for liver transplant is based on each person’s Model for End-Stage Liver Disease (MELD) score. The MELD system assigns a numeric score based on three lab test results:

  • Bilirubin (measures how effective the liver excretes bile)
  • INR/prothrombin time (measures the liver’s ability to make blood-clotting factors)
  • Creatinine (measures kidney function) 
While you are waiting for your transplant, your lab work will be done and MELD score calculated weekly to monthly as determined by UNOS requirements. The length of time waiting for a liver transplant depends on your medical condition as evidenced by your MELD score and other factors including your blood type, donor availability and your size.

You will be followed by our hepatology team here, and will also continue to be followed by your primary care physician and other specialists until transplantation takes place.

Transplant Phase

You must be reachable by phone at all times. When a liver becomes available for you, you will be notified by the pre-transplant coordinator and admitted to the Transplant Unit on the ninth floor of Rhodes Hall.

You will have multiple lab tests done to ensure you are ready for transplant. You will be given a number of medications, including antibiotics, antifungals and immunosuppression medications.

Ideally, surgery is performed as soon as the organ is available. However, using the latest perfusion techniques, we are able to transplant livers within 12 to 24 hours after organ recovery. The surgery will generally last from four to six hours or longer.

Post-Transplant Phase

After your surgery, you will be transferred to the Surgical Intensive Care Unit for at least 24 hours, then transferred to the Transplant Unit as soon as possible. Your hospital stay could be 10 days to two weeks, depending on complications and your condition.

You will be seen daily by the transplant surgeons, midlevel providers and discharge coordinators. You’ll receive individualized education from floor nurses and attend education classes on medication and general discharge instructions. The discharge coordinators manage your care process, communicate with insurance case managers and plan for discharge. A social worker will visit you to address any psychosocial issues associated with the transplant.

A post-transplant coordinator also will call shortly after discharge to answer any remaining questions and to discuss long-term follow-up with the transplant program.

Once you are discharged, you are followed on an outpatient basis with vital signs and laboratory profiles evaluated by a transplant coordinator and a transplant surgeon. Within one week of discharge from the hospital, you will be seen in the outpatient clinic and then adhere to the following schedule:
  • Weekly for two weeks
  • Every two weeks until eight weeks
  • Monthly for two months
  • Every three to six months until two years post-transplant. 
You will be seen annually thereafter, unless more frequent visits are required. After you are released by your surgeon, you will be seen by the Transplant Medicine Service. Lab frequency is reduced as you progress.

We will communicate with your referring physician at the beginning and end of each hospitalization, as well as with each outpatient clinic visit.

Because of the many interactions of other medications with immunosuppressives, please check with the post-transplant office prior to filling any prescription.

Treatment Team

Treatment Team

Treatment Team

Our Comprehensive Transplant Center treatment team includes:

Mid-Level Provider

This is a medical provider who is not a physician but is licensed to diagnose and treat patients under the supervision of a physician.
  • Marsha Bendle, MSBS, PA-C

Advanced Practice Nurse

The advanced practice nurse works closely with your physician to ensure continuity of care throughout your stay at the hospital and your transition to outpatient care. He or she orders and monitors diagnostic tests and treatments, responds to urgent needs, diagnoses and treats problems if they arise and provides the educational tools and resources necessary to continue success with your transplant once you are discharged.
  • Gerald Arnold, MS, APRN-BC, ACNS
  • Marsha Bendell, MSBS, PA-C
  • Rachel Bidwell, MS, CNP
  • Terri Miller, CNP
  • Lauren Phillips, MS, CNP

Transplant Coordinator

These are nurses who will be your primary contact from the time you are referred for a transplant evaluation throughout your care here. They will help answer any questions you may have and assist you throughout your transplant experience.

Pre-Transplant Coordinators:
  • Tara Bautista, RN, BSN, CCTC
  • Lindsay McDonnell, RN, CCTC
  • Marianne Shoemaker, RN, CCTC
  • Amber Swayne, RN
Post-Transplant Coordinators:
  • Julie Luebke, RN, BSN
  • Marilyn Moor, RN, BS
Hepatology Nurses:
  • Diane Faust, RN
  • Shandy Jasper-Williams, RN
  • Jackie McNutt, BSN
  • Amy Root, RN
Scheduler:
  • Brandie Snyder, MA

Social Worker and Psychologist

These professionals meet with you to evaluate your psychological readiness for transplantation.

Transplant Pharmacist

A transplant pharmacist works specifically with patients who have received a transplanted organ. This pharmacist has been trained to understand details about anti-rejection medications, works closely with your transplant physician to help manage your medications and helps answer medication questions you may have.
  • April Delahunty
  • Holli Winters

Pharmacy Patient Assistance Coordinator

She offers assessment, linkage and referrals for assistance to patients who need certain medications and have high co-pays or no prescription drug coverage.
  • Stacy Morton, 800-626-2538

Outcomes

Outcomes

Outcomes

Ohio State’s Comprehensive Transplant Center is a national leader in transplant success rates. 

Our one-year patient survival rate for liver transplant is 91 percent.

Source: SRTR data release July 2014

Frequently Asked Questions

Which health insurance are accepted?

The list of accepted insurances for liver transplant can often change. Please contact your healthcare insurance provider to confirm your coverage for transplant at Ohio State’s Comprehensive Transplant Center.

What is tissue typing?

Ohio State’s Tissue Typing Laboratory ensures that an organ is compatible with its recipient. The process involves matching a person’s unique configuration of six human leukocyte antigen (HLA) molecules with a potential pool of approximately 100 different varieties.

Cross-match testing helps prevent some types of organ rejection. The testing involves mixing cells from the donor’s and recipient’s serum to determine whether rejection-promoting antibodies will occur. This information helps your physicians plan for the right medication strategy to best control organ rejection.

Transplant support testing includes monitoring new drugs that patients use, testing to determine a patient’s overall ability to maintain a recipient’s organ and developing new tests to support many of the clinical aspects of transplantation.

Are there any support groups to join?

Buckeye GIFT (Giving Inspiration For Transplantation) Support Group, sponsored by Lifeline of Ohio, has open meetings providing support, education, awareness and advocacy for all individuals impacted by organ and tissue donation and transplantation including transplant candidates, recipients, donor families, living donors, medical professionals and families and friends of those touched by the Gift of Life. 

There are multiple meeting locations throughout Ohio. To learn more, visit the Buckeye GIFT website or contact the Community Events/Volunteer Coordinator at Lifeline of Ohio, 800-525-5667, ext. 375.
Our Doctors

Share this Page