Liver transplant tests

Your blood group is needed in order to find a suitable donor. This is just a simple blood test.

There are four blood groups - A, B, AB and O. Your blood group is determined by your genes. These are passed to you by your parents.

Your donor needs to be a compatible blood group to you.

Find out more about blood groups

You will have blood tests to assess the function of your kidneys, liver, and the ability of your blood to clot.

Your blood will be also checked for infection and diseases (for example HIV, hepatitis B, hepatitis C), as well as to monitor your general health.

High levels of antibodies in your blood make it harder to find a suitable liver donor. This is likely to mean a longer wait for a transplant.

These might include:

• A chest X-ray
• Lung function tests (spirometry)

These might include:

• ECG (electrocardiogram)
• Heart scan (echocardiogram)

A CT and/or an MRI scan will be performed to look at the anatomy of your liver including how the blood vessels attach to your liver. Sometimes these scans identify unexpected problems that may need further investigation. If you have hepatocellular cancer, the CT scan and MRI are important to assess the stage of your cancer and ensure that your cancer is within the criteria where transplant might be successful.

If these tests reveal any abnormalities then you may be referred to another specialty (cardiology, respiratory) for additional assessment.

The cardiology team may recommend that you undergo coronary angiography to help us understand how healthy your heart arteries are and whether there are any problems that could make the transplant too risky to carry out. This test is only required in selected cases.

When you have cirrhosis, the blood flow to and through your liver is not normal and this may affect the blood flowing through your heart and lungs. This may cause increased pressure in the blood vessels in your lungs (pulmonary hypertension or porto-pulmonary syndrome). If this is the case, then you may need to see a lung specialist and undergo cardiac catheterisation, which is similar to a heart angiogram. This test is only required in selected cases.

Sometimes these tests find major medical issues that mean a liver transplant is not possible.

You will likely be asked to exercise for a short period of time so your physical fitness can be assessed. This may be a cardiopulmonary exercise test (CPEX ‘bike test’) or a walking test. A CPEX test requires you to be exercised on a static bike to assess your body’s response to stress.

Fitness complications

If the fitness tests show that you are not ‘strong’ enough to withstand surgery then your transplant team may recommend a period of ‘pre-habilitation’. This involves a specially designed exercise programme to help improve your cardiovascular fitness. If you suffer from diabetes then you will be given help to improve your diabetic control as well as advice and assistance to help you stop smoking before surgery. Once this is complete then you may be re-assessed for a liver transplant.

Some patients need to see a psychologist or psychiatrist. This is especially important if you’ve had problems remembering to take tablets or issues with drug and/or alcohol use. The team looking after you need to make sure you’ll be able to take your post-transplant medication and not use drugs or alcohol.