Liver transplant program in San Antonio

As one of the top programs in the country for transplantation, hepatology and liver disease care, the Liver Disease and Transplant Program at Methodist Healthcare has performed over 500 transplants since 2001. On a percentage basis, we have transplanted more medically urgent patients than any other transplant facility in Texas.

To reach our Liver Transplant Clinic, please call (210) 575-4837.

Our program is led by a group of physicians with more than 60 years of combined expertise in all aspects of liver disease management, transplant services and procedures.

The goal of the Liver Transplant Program is to exhaust all medical therapies before resorting to a liver transplant, which is reserved as a final life-saving option.

The Liver Failure Clinic offers comprehensive treatment programs for liver failure management. Our hepatologist has extensive experience with the latest clinical treatments, including radiofrequency ablation and chemoembolization, as well as access to new clinical research and treatment protocols.

In addition, the Liver Failure Clinic offers ongoing educational sessions for patients and their families. Licensed nurses, dietitians, social workers and chemical dependency counselors provide information and answer questions regarding physical, psychological and social issues.

We also offer liver transplant services at:

Types of liver transplant

One type of liver transplant is a deceased donor transplant, in which a patient receives a liver transplant from a donor that has passed away. The potential recipient is placed on the United Network for Organ Sharing (UNOS) national donor waiting list. Because the donated liver must match the recipient's blood type and size, the waiting period can be a few weeks to several years. While waiting, the recipient must follow the physician's orders and be periodically evaluated.

Another type of transplant is the living donor partial liver transplant. Because the liver is the only organ to regenerate itself, new technologies have made it possible to remove a portion of a healthy liver for transplantation. This type of procedure is most often done for pediatric patients.

Liver transplant criteria

A liver transplant is performed in the case of end-stage liver disease (ESLD) or liver failure. Diseases and conditions resulting in end-stage liver disease for which transplantation may be necessary include:

  • Primary biliary cirrhosis
  • Sclerosing cholangitis
  • Liver cancer
  • Alcohol and/or drug abuse

Conditions that can develop into liver failure and may require a transplant include:

  • Hepatitis B virus
  • Hepatitis C virus

However, a transplant does not cure hepatitis. Early diagnosis and disease management can help patients reduce their risk of hospitalization.

Referrals to our liver transplant program

The first step in the transplantation process begins with a referral by the prospective patient's physician. Patients can be referred by filling out a secure, online patient referral form or by calling the clinic directly at (210) 575-4837.

Private insurance, as well as Medicare and Medicaid, provides coverage for liver transplants. However, the costs may not be fully reimbursed. Our financial coordinators can assist the patient with information and planning.

Liver transplant waiting list

The average wait for a liver is six to 12 months, and organs are allocated according to the Meld/Peld Scoring System. Some patients, depending on their clinical condition, will require hospitalization while waiting for their transplant. Patients who live outside of San Antonio may require temporary lodging near the transplant center during their wait.

We will assist out-of-town patients in finding housing accommodations for the immediate post-transplant period.

Liver transplant surgery

The liver transplant operation usually lasts approximately eight to 12 hours. An incision is made in the upper abdomen and the diseased liver is removed. The donor liver is reconnected to the major blood vessels and bile ducts, and the incision is then closed.

A tube is placed in the bladder for postoperative urine drainage. Surgical drains are also inserted around the incision to facilitate fluid drainage.

Liver transplant recovery

After surgery, the patient is taken to the Intensive Care Unit (ICU) and transferred to the hospital transplant unit when appropriate. Feeling weak and fatigued is a common post-operative experience. However, the patient can get out of bed, sit in a chair and walk with assistance.

Our specialists in physical therapy and rehabilitation work with the patient to gradually increase physical strength and activity endurance. Coughing and deep breathing exercises are also performed to clear the lungs.

Most liver transplant patients spend approximately 10 days in the hospital following their operation. However, each individual's recovery course varies, as some patients require a prolonged hospital stay.

After discharge, activity will be limited for six to eight weeks. Mild exercise, such as walking, is highly encouraged, but driving and heavy lifting are prohibited. The patient must keep a daily record of temperature, blood pressure, weight and doses and times medication is taken. Patients usually return to work within three months.

Potential risks after surgery

Infection and rejection are the main risks associated with transplants. Each transplant patient is prescribed immunosuppressive or "anti-rejection" medications. These medications prevent the body's immune system from rejecting the newly transplanted organ.

Because post-transplant medications are designed to suppress the immune system to reduce the risk of rejection, they also increase the risk of infection. Immediately following discharge, patients need to avoid large crowds and contact with unhealthy individuals.