Return to University Health's Homepage.

Liver Referral Criteria & Process

Contact us

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 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)


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 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.

  1. Chandraprakash Umapathy, MD
    Chandraprakash Umapathy, MD
  2. Christine Toth, MD
    Christine Toth, MD
  3. Jose Almeda, MD
    Jose Almeda, MD
    General Surgery Transplant