Liver Referral Criteria & Process

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Please call the Transplant Institute at 210-567-5777 for more information.

Liver Referral Criteria & Process

Refer your patient with liver disease to University Health’s transplant program for compassionate, advanced evaluation and treatment.

Reasons for a Liver Transplant Referral

You may recommend a patient for a liver transplant evaluation if he or she has one or more of the following liver conditions:

  • Acute liver failure from viral hepatitis or drug toxicity
  • Alcoholic cirrhosis – Patients with alcoholic cirrhosis are considered for transplant if they can achieve abstinence and rehabilitation
  • Cholestatic diseases such as primary biliary cholangitis, primary sclerosing cholangitis, secondary biliary cirrhosis and cystic fibrosis
  • Chronic hepatitis, hepatitis B, hepatitis C, hepatitis D, autoimmune chronic active hepatitis, cryptogenic cirrhosis, chronic drug toxicity or toxin exposure
  • Chronic liver disease limiting your patient’s quality of life and ability to work
  • Irreversible liver disease with no effective treatment alternatives
  • Metabolic diseases such as hemochromatosis, Wilson's disease, Alpha-1-antitrypsin deficiency, glycogen storage disease, tyrosinemia, familial amyloidotic polyneuropathy, other metabolic disorders treatable by liver replacement
  • Predictable mortality from liver disease exceeding transplantation prognosis (85% one-year survival, 70% five-year survival)
  • Primary liver tumors – Select patients with hepatocellular carcinoma (HCC)

Liver Transplant Eligibility

Consider whether your patient meets our referral criteria for a liver transplant evaluation.

Reasons Not to Refer for a Liver Transplant

We will not consider your patient as a liver transplant candidate if he or she has:

  • Active drug or alcohol use
  • Patient history indicating other end-stage medical conditions
  • Metastatic cancer

Behavioral Assessment Requirement

Count on us to perform a required psychiatric assessment of a patient who does not meet alcohol or drug abstinence requirements in the initial evaluation.


If your patient does not meet the referral criteria, he or she may return for re-evaluation at a later date.

Three-Step Liver Transplant Referral Process

When your patient meets all the referral criteria, follow our three-step referral process for adult liver transplantation:

  • Within 24 hours of receiving your patient referral, we will contact your office by phone and/or email to:
    • Confirm receipt of your referral
    • Confirm receipt of all patient information
    • Notify you and your patient of the initial evaluation date
    • Answer your questions and provide support

Advanced Liver Treatments

Find advanced medical and surgical liver care and treatments at University Health for conditions that may prevent transplantation. Call 210-567-5777 or 1-888-336-9633 to talk to one of our transplant physicians or coordinators.