Information for Referring Physicians
What is Liver Transplant Waiting List?
This is a centralized computer data base containing medical record of all patients who are found suitable for Liver Transplantation surgery after a detailed, standardized, scientific work up at a Liver Transplant Assessment Clinic.
How was Liver Transplant Waiting List Started?
Liver Transplant Waiting List was conceptualized in line with the existing working of the United National Organ Sharing in the United States to create a National data base in Pakistan of all patients who may be found eligible to be considered for Liver Transplantations surgery. This list is currently used by the Liver Transplant Clinic at Shifa International Hospital, Islamabad as an integral component of their Liver Transplant program.
How is the Liver Transplant Waiting List maintained and upgraded?
All patients referred to the Liver Transplant Clinic at Shifa International Hospital, Islamabad undergo a detailed assessment and as per an agreed laid down scientific protocol. If the Liver Transplant Clinic determines that the patient is a transplant candidate, they add the medical profile of the patient on the Liver Transplant Waiting List.
All patients on the Liver Transplant Waiting List are offered preferential and individualized pre transplantation care and follow up to continuously review and monitor their progress.
A patients name may be removed from the Liver Transplant Waiting List if the assessment and follow up team discovers that a contraindication has arisen which makes the patient in-eligible for a Liver Transplant at a future date. Similarly, many patients might deteriorate and die as a result of complications while waiting for a suitable time and donor while being on the Liver Transplant Waiting List. Their names are also removed from the list. This process of up gradations continues on a regular basis.
What is the Future of existing Liver Transplant Waiting List?
We appreciate and acknowledge that a number of other individuals and institutions have already been working in the area of liver Transplantation in Pakistan. Many of these programs are at an advanced stage of commencement and a few are already offering a high quality of patients care in this area. It is our ultimate aim to create close national networking with these existing high quality Liver Transplant Programs to compliment each others efforts in bringing Liver Transplantation surgery to Pakistan on a more durable basis.
We strongly believe that a National Liver Transplant Waiting List might prove to be a solid link to create such an organized and long term partnership. It is anticipated that all likeminded and same quality Liver Programs within the country would ultimately agree to adopt a common Liver Transplant Waiting List protocol to enlist eligible candidates for Liver Transplantation to create a National Liver Transplant Waiting List.
Liver Transplant Web
It is our endure to create a Liver Transplant Web to enable all participating programs to enter medical data of eligible transplant candidates on the anticipated National Liver Transplant Waiting List via this computer network. This will also serve as a communication link between various participating programs to share mutually beneficial information with other colleagues.
Prioritization for surgery while on the Liver Transplant Waiting List
Most patients on the Transplant Waiting List would receive a Living Donor Liver Transplant. The rules for Living Donor Transplantation are very strict and would normally mean that a relative or family friend or member of a family of a patient on the Liver Transplant Waiting List will be the expectant donor.
Prioritization for Liver Transplant surgery for patients on the Liver Transplant Waiting List would, therefore, not follow rules which are applicable in other countries for a similar waiting list. It is, however, our aim to improve and make effective our fund raising program to a level where a certain number of transplant surgery is offered free of cost to patients on the Liver Transplant Waiting List.
We would apply the universally accepted, standardized organ allocation rules at that stage of the program. These rules are already well known and agreed upon through out the world and generally follows the principle of the sickest get the top priority. As a general guidance, it is important to know that funds allocation to different patients will be done according to the urgency of need of the Liver Transplant surgery in the context of severity of underlying liver condition. This is done using a universally accepted and applied MELD score used to determine the severity of underlying liver condition.
Often, the top patients on the Liver Transplant Waiting List might not get the funds for surgery for one of several reasons. Apart from the current health status, fitness for operation and psychological well being, there are other important factors which might influence the surgical priority like ABO groups etc.