Once patients are placed on the transplant waiting list, care is coordinated between the local physician’s office and Cleveland Clinic hepatology. Follow-up appointments with the patient’s Cleveland Clinic hepatologist are generally scheduled every 3 to 6 months.
More frequent appointments can be scheduled depending on the patient’s MELD score or change in medical status. Components of the list management protocol are:
- Lab studies – are updated as directed by UNOS for MELD score calculation and prn.
- Echocardiograms and stress tests – are updated yearly and at the discretion of the anesthesiologist.
- Duplex ultrasonography – is done every 6 months to assess vasculature and for hepatoma screening.
- HCC – Bone scan, Chest CT , AFP Q 3 months
- Hepatitis B – If HBV-DNA or HBeAg positive, hepatology will begin antiviral therapy. HBV-DNA, HBeAg, HBeAb Q 3-6 months (with each follow-up visit)
- Primary Sclerosing Cholangitis – CA19-9, CEA Q 3-6 mos (with each follow-up visit)