How do doctors decide if you need a liver transplant?

This is a complex decision and involves lots of specialists

Key points

  • You will need tests to see if you’re fit enough to cope with liver transplant surgery
  • Your case is then discussed by a team of specialists
  • The decision-making is complex, taking into account many factors
  • A clinical score (UKELD score) is used to decide who might benefit from a liver transplant

Liver transplant assessment test

If you develop decompensated end-stage liver disease, your consultant may refer you for an assessment at a liver transplant centre. This may be as an inpatient or an outpatient, depending on the centre. The assessment will involve blood tests, CT/ MRI scans and fitness tests.

Learn more about liver transplant tests

Decision-making process

Your case will be discussed in a multidisciplinary meeting where a recommendation will be made. This brings together surgeons, hepatologists (liver doctors), anaesthetists, intensive care specialists, liver transplant coordinators, a dietician, social worker and in some cases a psychiatrist. These specialists will assess the findings of your assessment tests.

The decision-making is often complex and takes into account your clinical condition, family support and potential for recovery without a liver transplant.

The decision to offer a place on the national waiting list is based on both the benefits that a transplant can bring and the risks associated with this treatment.

Clinical score

A clinical score (UKELD score) is used to decide who might benefit from a liver transplant for most patients. There are some patients who have liver diseases where a UKELD score is not helpful.

What happens next?

National criteria for selecting patient suitable for a liver transplant

All transplant teams in the UK must follow the national criteria for selecting patients suitable for a liver.

View the national criteria for selecting liver transplant patients (POL195)

More information

Medical terms explained



Antibodies are proteins produced by your immune system. They recognise and fight against foreign substances, such as germs (bacteria, viruses) or ‘foreign’ tissue types. Certain antibodies in your blood can make it more likely for your body to reject your transplanted liver.



These are substances that cause an immune response in the body.



This is when a very small piece of tissue is taken for analysis.


View all medical terms 


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