Liver Transplant Patient Guide
Lab Tests and Procedures
A usual lab test monitors blood count, clotting, kidney function, liver function, electrolytes, and medication levels in the patient's blood. Other tests may be ordered as necessary.
Tests for BLOOD COUNT:
- WBC tell if the patient's white blood cells have increased (usually a sign of infection) or decreased (indicating a lower defense against infection).
- HCT measures the hematocrit, which is the percentage of red blood cells in the blood. Red blood cells carry oxygen to all parts of the body. When a patient's HCT is low, he may feel tired or have little energy.
- PLT measures the level of platelets. Platelet cells form a blood clot when the body is injured. Low platelet levels may cause someone to bruise easily and to bleed for a longer time when injured.
Test for KIDNEY FUNCTION:
- Creatinine and BUN tell how well the kidneys work by measuring levels of creatinine and blood urea nitrogen, waste products normally removed from the blood by the kidneys.
Tests for LIVER FUNCTION:
Tests for ELECTROLYTES (dissolved minerals):
- Bili measures the level of bilirubin, a normal byproduct when hemoglobin from red blood cells breaks down. The liver removes bilirubin from the blood and excretes it in the bile. When the liver is not functioning normally, bilirubin levels can increase, often resulting in jaundiced (yellowed) skin and eyes.
- Alk Phos measures alkaline phosphatase, which is made in the bones, liver, pancreas, and intestines and removed from the blood by the liver.
- AST, ALT, and GGTP test enzymes that are made in the liver. These tests tell how well the liver is working.
Other blood tests:
- Ca measures calcium, which is necessary for strong bones and teeth, blood clotting, and heart and nerve function.
- PO4 measures phosphate, which works closely with calcium to strengthen bones.
- Mg measures magnesium, which is necessary for normal functioning of muscles and for blood clotting.
- K measures potassium, which is needed for normal heart and muscle function.
- Na measures sodium, which helps maintain the balance of salt and water in the body.
- Drug levels measure PROGRAF or SANDIMMUME in the blood. PROGRAF or SANDIMMUNE blood levels must be checked regularly to avoid levels that are too high or too low. High levels could lead to toxicity or over-immunosuppression, and low levels may lead to rejection.
NOTE: The desired level (normal range) will differ for each person, depending on the combination of immunosuppressive medications and the length of time since the transplant.
- Glu measures glucose, levels of sugar in the blood; some medications may produce a diabetes-like condition in which blood-sugar levels are too high.
Additional Tests and Procedures
The transplant team may perform one or more of the following tests and procedures to monitor a patient's transplant:
- Ultrasound - This test is performed to make sure all the main blood vessels leading to the liver are functioning normally. This test is also used to check for collections of fluid, such as blood or bile. The procedure consists of placing a cool gel on the patient's abdomen, over which a wand (transducer) is moved to transmit sound waves. These are converted into images of the liver and projected onto a television screen.
- Percutaneous transhepatic cholangiogram (PTC) - This is an X ray that shows the patient's bile ducts to check for leaks, blockages, or other potential problems. The procedure starts with a dye injection into the T-tube. The dye makes the ducts easy to see on X ray. If a T-tube was not placed during your surgery, this X ray will be performed after dye has been injected directly into the liver-bile ducts.
- Liver biopsy (test sample) - This test is usually performed to check for rejection, hepatitis, or other possible problems. This may be done in the hospital or in the outpatient/short-stay unit. The patient will receive special instructions regarding the procedure. Before the procedure, the patient will receive a numbing injection (local anesthetic) on the right side of his abdomen. Then a special needle will be inserted to withdraw a small sample of liver tissue that will be examined with a microscope. After this procedure, the patient must lie on his right side for at least 1 hour and stay in bed for about 4 hours.
- Computerized tomography (CT) scan - This is a type of X ray that allows the physician to view the patient's liver from many different angles to detect infections, fluid collections, or other problems. The procedure requires that the patient drink a liquid that outlines his stomach and intestines and makes his liver more visible; then he lies flat for 1 hour while the machine takes X rays around him.
- Magnetic resonance imaging (MRI) - This is another type of test that produces an image. Somewhat like a CT scan, it also allows a patient's liver to be viewed from different angles and in three-dimensional images. An MRI shows soft tissues, such as the liver, more clearly than a CT scan does.
- Endoscopic retrograde cholangiopancreatogram (ERCP) - This test allows the physician to see the patient's biliary tree (the various ducts in and around the liver), as well as the ducts from the pancreas. The patient will be given medicine to relax him before the procedure. An endoscope (a type of tube) is placed in his mouth; it is advanced through to his stomach and into his intestine to the liver. A dye is then infected through the endoscope that makes the ducts visible in X rays.
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USC Hepatobiliary, Pancreas and
Abdominal Organ Transplant
1450 San Pablo Street
Healthcare Consultation Center 4
Los Angeles, CA 90089
For Liver, Pancreas & Bile Duct Surgery,
please call (323) 442-7172
Fax: (323) 442-7173
For Organ Transplant Information,
Fax: (323) 442-5721