If you have a condition that may lead to liver failure, visit the UNC Center for Transplant Care at UNC Medical Center before your disease advances. Our compassionate team of experts believes it’s best to consider your options early. That way, we can build a strong relationship and give you the best possible care—so you can enjoy a better quality of life.
Experts in Liver Transplant
When you choose UNC Medical Center for a liver transplant, you benefit from our experience and a multidisciplinary, collaborative approach that brings you the latest treatment techniques.
Since the fall of 1991, specialists at the UNC Center for Transplant Care have performed more than 1,000 adult and pediatric liver transplant procedures. You know you’ll get top quality care because our one-year survival rate of 89 percent exceeds the national average.
On several occasions, UNC has received a bronze-level transplant program award from the Health Resources and Services Administration (HRSA)of the US Department of Health and Human Services for our pre-transplant survival rate. We also are recognized by OptumHealth as a Center of Excellence for liver transplant and by Blue Cross Blue Shield as a Blue Distinction Center for our adult liver transplant program because we have a proven track record of delivering better overall outcomes for our transplant patients.
If you’re facing a liver transplant due to liver cancer, you can receive comprehensive treatment for your cancer from oncologists at the largest liver cancer treatment program in North Carolina.
Conditions That May Require a Liver Transplant
At UNC Medical Center, you’ll find a team that’s especially well-known for treating liver cancers, viral hepatitis and fatty liver disease, and has performed liver transplants for many conditions, including:
- Acute (fulminant) liver failure – A rapid loss of liver function, usually with no pre-existing liver disease
- Cholestatic liver disorders – Liver disease caused by blocked or slowed bile flow
- Cirrhosis – Scarring of the liver caused by chronic liver disease
- Hepatitis C or B – Inflammation of the liver due to viral infections
- Autoimmune hepatitis – When the body’s immune system attacks the liver, causing damage
- Hepatocellular carcinoma (HCC) – The most common type of liver cancer
- Non-alcoholic fatty liver disease (NAFLD) – A build-up of extra fat in liver cells not caused by alcohol
- Primary sclerosing cholangitis – A build-up of bile in the liver due to inflammation, scarring and narrowing of the bile ducts
- Inherited disorders such as Alagille’s syndrome, alpha-1 antitrypsin deficiency, hemochromatosis and metabolic disorders
- Congenital conditions such as biliary atresia
Specialized Facilities and Services
You’ll find dedicated hepatology and transplant facilities and services at NC Memorial Hospital on the UNC Medical Center Campus and our outreach clinics in Asheville, High Point, Raleigh and Wilmington, including:
- Specialized operating rooms for liver and transplant surgery
- Intensive care units (ICUs) staffed by nurses specially trained in the care of transplant patients
- An extensive post-transplant rehabilitation program to get you back to the activities you enjoy
- Specialized services for pediatric transplant patients and their families
- State-of-the-art Magnetic Resonance Imaging (MRI) and CT Scanning
- Comprehensive therapeutic vascular interventional radiology
- Comprehensive endoscopy, including ERCP, endoscopic ultrasound, and choledochoscopy
- Cutting-edge chemo-therapeutic protocols for liver cancer
Conformal external beam radiotherapy for liver cancer (Cyberknife)Transplant assessment, evaluations and follow-up care are available in our outreach clinics, so you can get care close to home. Other services are located at NC Memorial Hospital in Chapel Hill.
When you choose UNC for your transplant, you have access to extensive support services. Learn more about additional services for you and your family.
Coordinated Care Every Step of the Way
Dedicated liver transplant coordinators will serve as your expert guides and support people from your initial evaluation through surgery and beyond. These specially trained nurses will arrange your medical tests, listen to your concerns, answer questions, act as a liaison between you and the rest of your transplant team, teach you how to care for your body after a transplant and more.
Liver Transplant Evaluation
After your doctor refers to you to the UNC Center for Transplant Care, you’ll start with a comprehensive evaluation. We’ll learn about you, your medical condition and how you and your family or other caregivers would cope with the stress of a transplant procedure. It’s also an opportunity for you to get to know us and learn more about liver transplantation.
You’ll meet with our specialists—including dedicated transplant hepatologists, surgeons, psychiatrists and social workers—and go through a series of routine tests, including:
- A Pap smear and mammogram for women
- Blood tests for hepatitis, HIV and other immune sensitivities
- A chest X-ray to check your heart and lung health
- Pulmonary function tests – Exams that measure how well your lungs take in and release air
- Cardiac evaluation – Tests that measure the condition of your heart
- A PPD skin test for tuberculosis
- Abdominal Magnetic Resonance Imaging (MRI), magnets and radio waves to create pictures of the inside of the belly area
- A duplex Doppler scan of your liver – An ultrasound procedure that looks at how blood flows through your arteries and veins
- A kidney (nephrology) evaluation, if indicated
If you have an urgent liver problem, please call Carolina Consultation Center at 1-800-862-6264 and ask for the attending hepatologist on call. Depending on urgency, your first appointment may be withing 24 hours to 2 weeks of referral, but the transplant testing may occur over multiple outpatient visits.
Liver Transplant Candidacy & Pre-Transplant Care
If tests and screenings show you’re a good candidate for a liver transplant, you’ll be listed with the United Network for Organ Sharing (UNOS). Your priority on the list will be determined by how urgently you need a transplant and your blood type. This is tracked by the Model for End-Stage Liver Disease (MELD) scoring system for people age 12 and older and the Pediatric End-Stage Liver Disease (PELD) scoring system for children younger than 12. If you have liver cancer or a unique liver-related disorder, you may qualify for higher priority.
While you wait for your liver, you’ll meet regularly with your hepatologist in our pre-transplant clinic. We’ll also stay in close contact with your referring doctor in order to keep you in the best health possible.
If you’re not a good candidate for transplantation, your hepatologist will help you determine the best treatment option for your condition.
Liver Transplant Surgery
Following your transplant surgery, you’ll recover in the intensive care unit (ICU), then move to a special transplant unit; you may be in the hospital 7 – 10 days depending on your condition. Your doctors and nurses will monitor you closely in order to identify and treat any potential problems as soon as possible. You’ll also begin taking anti-rejection medications to give your body the best chance of accepting your new liver.
During the operation, your liver will be removed and the new one will be placed in the same location. Your new liver will then be attached to your blood vessels and common bile duct—the tube that carries bile from your liver and gallbladder into your small intestine. Liver transplant surgery can take from 6 to 12 hours.
Liver Transplant Follow-Up Care
When a donor liver becomes available, your transplant coordinator will contact you and preparations for your surgery will begin.
After you’re released from the hospital, you and your referring physician will stay in close contact with your transplant team to track your progress and watch for complications. Your UNC Center for Transplant Care team will always be available for questions or follow-up care.
Most people who have a liver transplant are able to return to normal activities after several months.
Hope Abounds' After Liver Transplant
After receiving a liver transplant due to a rare overproduction of red blood cells, Heather Ledbetter, of Flat Rock, and her family found the extra recovery care and support they needed at UNC Medical Center’s SECU Family House. Her Aunt, Linda Cairnes said, "We felt safe there, and everyone there knows you are going through something and they are willing to help". Learn more about Heather's transplant surgery and recovery.