Who can have a liver transplant?

Transplanting the liver is possible in a few people with primary liver cancer. A transplant may be suitable for you if you have  

• A single tumour no more than 5cm across
• A single tumour no more than 5 to 7cm across if it has been stable for at least 6 months  
• 3 small tumours no larger than 3cm across each 

To have a liver transplant you need a donor liver that is a close match to your own. You may have to wait a long time.

A liver transplant is not useful if the cancer has spread out of the liver, because there will be cancer cells left behind in the body after the operation. So the operation would not get rid of all the cancer.

You may not be able to have a liver transplant if you have very severe liver cirrhosis. Your specialists will have to judge whether you would be well enough to get through the operation and recovery period. If not, a transplant may not be in your best interests because there would be too big a risk of not surviving the operation.

If your doctor decides that a liver transplant may be suitable for you, you will be admitted to hospital for an assessment. This can take between one and two weeks. It is important that your doctor knows how well your liver is working before you have surgery. To get information about this, your doctor will ask you to have detailed blood tests called liver function tests. You will also have a number of other tests to help decide if a transplant is the best form of treatment for you.

Having a liver transplant involves a lot of careful preparation from a number of different health care workers. You will meet these people during the assessment. Take this time to get to know them and ask as many questions as you want to. That is what they are there for and it is best that you go into the operation feeling well prepared.

If you and your doctor decide to go ahead with the liver transplant, you will need to have several more tests before your surgery. This may mean going into hospital a few days before your operation.

Your donor liver needs to be from someone about the same weight and blood type as you. Most livers used for transplantation come from people who have agreed to donate their liver when they die. It is normal to have some mixed feelings about this. Your doctors will discuss this in detail with you and answer any questions that you may have.

Some people can have liver tissue donated from another person (living donor liver transplantation). The liver can grow back very quickly after it has been partly removed. So the idea is that a donor gives you part of their liver. This potential treatment is still very experimental and there are risks for the donor as well as the person receiving the liver tissue. There is more information about this in the liver cancer research section of CancerHelp UK.

If a liver transplant is a suitable treatment for you, your name will be placed on a waiting list for a donated liver. Unfortunately there are a lot more people on the waiting list than there are livers available each year. Depending on how well you are, you will either wait for your liver transplant at home or in hospital. No one will be able to tell you exactly when a liver will become available.

Some people will only have to wait a few days but for others the wait may be longer, possibly a few months. This waiting time can be extremely difficult for you and those close to you. You may find yourself thinking about it all the time and worrying that it will never happen. There may be times when you are feeling unwell and wonder if you will still be fit enough to have the transplant when a liver does finally become available. Your doctors and nurses are aware of this and will try to support you through it as much as they can. If you are worried or feel ill, do not hesitate to contact them for advice. You will have regular check ups at the hospital while you are waiting for a liver to become available. This will give you the opportunity to ask any questions that you have.

If you are well enough to wait at home, it is very important that you can be contacted at all times. If you are going away, you must let your hospital know. You will need to carry a mobile phone with you. This will give the hospital a sure way of contacting you at all times.

When a liver becomes available, you will be contacted immediately. You should always have a bag packed ready to take into hospital. You will need to get there very quickly once you have been contacted. If you arrive at the hospital and then the liver is found to be unsuitable for you, you will have to go home and wait until another liver is available. You are bound to feel very disappointed, if not angry. But your doctors and nurses will support you as much as they can.