Note: Memorial Hermann – Texas Medical Center’s (Memorial Hermann) liver transplant program is voluntarily inactivated. On March 22, 2024, Memorial Hermann was made aware that a single physician made inappropriate changes to the donor acceptance criteria within the United Network for Organ Sharing (UNOS) transplant information database for patients awaiting a liver transplant at Memorial Hermann. “Donor acceptance criteria” refers to factors such as the age and weight of deceased donors whose livers are being made available for transplant. Upon learning of this activity, Memorial Hermann immediately began an investigation, and chose to voluntarily inactivate its transplant program. Memorial Hermann has not identified any impact to any other transplant program other than the liver transplant program. At this time, there is no timeframe for the reopening of the liver transplant program. All liver transplant patients on the transplant waitlist have been transferred to another transplant program.

The liver performs many essential functions. It makes the factors that the blood needs for clotting, aids in digestion and breaks down toxic substances (including drugs and alcohol) in the blood. If your liver fails, a liver transplant – surgery to replace your diseased liver with a healthy liver from another person – can save your life. The liver is the second most commonly transplanted organ in the U.S., after the kidney.

Liver Transplant Team

The multidisciplinary liver transplant team at the Transplant Center is comprised of specialty trained transplant hepatologists, transplant surgeons, transplant nurses, transplant anesthesiologists, transplant coordinators, financial counselors, social workers and dietitians.

Through our partnership with the Ertan Digestive Disease Center, we provide quality treatment for patients with liver disease. Our affiliation with McGovern Medical School allows us to offer clinical trials that further the scientific understanding of liver disease, as well as advanced treatment protocols that keep us at the cutting-edge of liver disease treatment.

The Organ Donation Process

Life-saving transplantation is made possible through the generous “gifts of life” by donors. While living, these individuals registered to become donors (upon their death), either when signing up for or renewing their driver’s licenses or through the registry. If a deceased patient has not registered but is a candidate for donation, his or her next-of-kin can provide consent for donation on his or her behalf. Currently, about half of Texans are registered donors, and there are over 100,000 individuals awaiting organ transplants in the U.S.

Upon a donor’s death, the donor’s organs and/or tissues are recovered by an organ procurement organization (OPO). The OPO serving the Greater Houston area is LifeGift. To learn more about the organ donation process (for donation from deceased donors), please visit the LifeGift website.

What Is the Liver Transplantation Process?

Liver Transplant Evaluation

Once the medical team and patient have chosen the path of transplantation for treatment, the patient will receive a thorough evaluation from the liver transplant team, which includes transplant hepatologists, transplant surgeons, transplant nurses, financial counselors, social workers and dietitians.

The overall evaluation takes approximately three days and includes:

  • Diagnostic & Blood Testing, including blood tests, x-rays, ultrasounds, CT scans and cardiac testing.
  • Appointments to See Other Specialists, such as cardiologists, gynecologists, urologists and gastroenterologists, as necessary, to determine if it is safe to proceed with kidney transplantation.
  • Psychosocial Evaluation, to help prepare the patient and loved ones for liver transplantation. Financial counselors are also available to help make necessary arrangements prior to transplantation.
  • Patient Education, to help the patients and their loved ones fully understand the transplant process, a crucial step in successful kidney transplantation.

Once the evaluation is complete and the results of the tests are received, the multidisciplinary transplant team will confirm that liver transplantation is the correct option for the patient. After being confirmed as a transplant candidate, the patient will be placed on the national waiting list for deceased-donor liver transplantation.

MELD Score and the Liver Transplant Waiting List

Livers from deceased donors are a scarce resource. In order to distribute this scarce resource most fairly, liver patients are ranked on the waiting list according to the severity of their illness.

The Model for End-Stage Liver Disease (MELD) score is based on three specific laboratory tests: bilirubin, INR and serum creatinine. The MELD score ranges from 4 to 40 and is used to rank patients on the waiting list.

Patients with higher MELD scores get first priority when a liver becomes available. In some cases, patients with certain diseases such as liver cancer may receive additional MELD points based on their disease.

Patients awaiting liver transplantation on our transplant list are seen by Transplant Center physicians on a regular basis to ensure that they will be ready for transplantation when a liver becomes available.

Liver Transplant Procedure

When a liver becomes available, the patient is notified and immediately admitted to the hospital, where the patient meets with a transplant hepatologist and a transplant surgeon, who will answer the patient’s questions. Prior to surgery, the patient will sign a consent form authorizing the procedure.

Liver transplantation is a major operation, performed under general anesthesia, that requires a specialized team of surgeons, specialized transplant anesthesiologists and operating room staff. The procedure, which involves removing the patient’s diseased liver and implanting the new one, usually takes 4-6 hours but may take longer in patients with prior abdominal surgery.

Following the procedure, patients are taken directly to a dedicated Transplant Surgical Intensive Care Unit (TSICU) to recover. All patients will have a urine catheter and a special IV for administering medications, both of which are typically removed within two days of transplant. In addition, the patient will have several abdominal drains in place for several days, and a small drain in the bile duct.

Most patients are in stable condition and are awake the same day as their liver transplant. The majority of patients are transferred out of the TSICU to the regular transplant surgery floor within two days of their transplant. Eating, drinking and walking are strongly encouraged as soon as possible after transplant. Most patients are discharged from the hospital within a week of their surgery.

What Are the Possible Risks of Transplantation?

Liver transplantation carries associated risks, including the risk of the body rejecting the implanted liver, the risk of infection and the increased risk of cancer or elevated blood sugar from the immunosuppression (anti-rejection) medication administered to reduce the risk of rejection.

It is important to know that rejection does not usually mean loss of the transplanted organ. Rather, rejection simply means that the balance of the immune system and the organ has changed and that immunosuppression needs to be increased. Your doctor will discuss all of the risks associated with transplantation with you prior to your procedure.

Patient Stories

  • Memorial Hermann transplant recipient RoxAnn smiles alongside her daughter.

    RoxAnn's Story: One Woman, Two Liver Transplants

    June 2, 2021

    RoxAnn Martinez has had three livers. The 56-year-old from Baytown, just outside of Houston, has the care she received at Memorial Hermann Health System and two liver donors to thank for giving her a second – and third – chance at life.

    Read More
  • Jennifer and her transplant team

    Jennifer's Battle with Cirrhosis

    May 17, 2019

    When Dr. Hall first saw Jennifer, her weight had swelled to more than 200 pounds from the buildup of fluid from both liver and kidney failure. “She was so ill, so swollen. She couldn’t even walk,” Dr. Hall remembers. Transplant was her only hope, but the volume of water in her b...

    Read More
  • Ezra

    Donate for Life: Ezra's Story

    April 16, 2015

    After Ezra's family started to notice him getting sick, they sought medical advice before finally ending up at Children's Memorial Hermann Hospital for care. Ezra's rare disease led to him needing a liver transplant. After finding a match, his medical team went into action to perform the transpla...

    Read More

Liver Transplant Recovery

The goal of liver transplantation is to return patients to a full, satisfying quality of life after surgery, returning to school, work, sports and other activities they enjoyed prior to developing liver disease. This recovery to normal function may take months after liver transplantation, depending on the severity of liver disease before transplantation.

Although the hospitalization is relatively short post-transplantation, our physicians and staff continue to monitor recent liver recipients very closely in the clinic, where patients enjoy the comfort of home as they recover, while receiving the medical attention they need.

Clinic visits are scheduled weekly or twice-weekly during the early period post-transplant, and the time between visits will increase according to the patient's needs. Patients from outside the Greater Houston area should plan to stay in Houston for 4 to 6 weeks after transplant to ensure that this close follow-up is possible.

Transplant Support Group

Transplantation can sometimes seem overwhelming for patients. The Transplant Center offers a transplant support group, run by our transplant social workers. The group meets monthly and includes patients who are waiting for a transplant as well as those who have already received a transplant. Adult family members, friends and caregivers are welcome and encouraged to come with the patient.

To learn more about our transplant support group, call (713) 704-5200.