Overview

Overview

The Transplant Center at Cleveland Clinic in Florida is among a select few in the state offering living donor liver transplant services. We help patients with advanced liver disease and liver failure get liver transplants faster. In collaboration with the Transplant Center at Cleveland Clinic in Ohio, we’re one of the nation’s largest and most experienced providers of liver transplants.

Liver Transplant Program at Cleveland Clinic in Florida: Why Choose Us?

Patients who come to us for liver transplants benefit from:

  • Proven liver transplant success: More than 8 in 10 patients who get a liver transplant with us experience a three-year survival. Our patient survival rates are similar to national averages. See if you’re a liver transplant candidate.
  • Expanded access to donor livers: You have more transplant options with us. We are one of the few providers in Florida providing living donor liver transplants. We also have the expertise to transplant livers from deceased donors whose age, health status or other factors previously made donation impossible (expanded criteria donors). Learn more about our living donor programs.
  • All types of liver transplants: Our liver transplant team has deep experience performing all types of liver transplants. We also offer complex multi-organ transplants. We consider each patient’s unique situation and the availability of a compatible donor liver. See the types of liver transplants we offer.
  • Liver transplant expertise: Patients from across Florida and from nearby states and countries come to us for our proven liver transplant expertise. We also provide ongoing post-transplant care for patients who had liver transplants at other centers. Find out what to expect from a liver transplant.
  • Access to clinical trials: Our liver transplant experts are leading national clinical trials for technologies to minimize liver cell damage before transplantation. Our team is active in a wide breadth of research and clinical trials to improve liver transplant outcomes. Learn how to participate in a clinical trial.

Specialized liver disease services

Patients with common to complex liver disease receive the highest-level medical care at our comprehensive Center for Liver Disease. Our team of experts provides medical and surgical treatments, including liver transplants, for all types and stages of liver disease.

Cleveland Clinic in Florida is also home to South Florida’s only multidisciplinary Liver Tumor Clinic.

Nationally recognized medical care

Liver transplants take place at our Cleveland Clinic Weston Hospital, named South Florida’s top hospital by Newsweek. Cleveland Clinic in Florida hospitals consistently rank among the best in the state. Learn more about our recognitions and rankings.

Team approach to liver transplantations

You receive comprehensive care from our liver transplant team and specialists from other medical fields. We communicate with your referring physician throughout the transplant process.

A dedicated liver transplant nurse coordinator serves as your primary point of contact. These specialists guide you and your family through the liver transplant journey.

Care team members may include experts in:

Liver Transplant Candidates

Liver Transplant Candidates

The liver transplant team at the Cleveland Clinic in Florida Transplant Center conducts comprehensive screenings to determine transplant eligibility. We work closely with your referring physician to evaluate your health and the urgency of a liver transplant.

Indications for a Liver Transplant

Many people who need a liver transplant have some type of liver disease. Acute liver disease happens suddenly, often from infections or medication complications. More commonly, chronic liver disease causes gradual liver damage over months or years.

Even with proper medical care, liver disease can cause scarring called cirrhosis of the liver. Scar tissue replaces healthy liver tissue, eventually leading to liver failure. Liver failure is also known as end-stage liver disease (ESLD).

About liver failure

When you have liver failure, your liver struggles to make bile. This substance helps break down foods. It also can’t make proteins for blood clotting or remove harmful substances from the body. A scarred liver restricts blood flow, leading to a serious type of high blood pressure called portal hypertension.

Liver experts (hepatologists) at our Center for Liver Disease provide comprehensive treatments for many causes of chronic liver disease and liver failure. But a liver transplant is the only cure for life-threatening liver failure.

Conditions that cause liver failure

Many conditions can damage the liver and cause liver failure, such as:

Liver Transplant Evaluation Process

Every potential liver transplant candidate completes extensive physical and psychosocial health evaluations. These tests ensure you can undergo major surgery. We also make sure you have a good support system in place for post-transplant recovery.

Tests to determine liver transplant eligibility include:

  • Liver function tests: These blood tests show how well your liver is working. Liver function tests include a bilirubin test and an elevated liver enzymes test.
  • Imaging scans: Our imaging services team uses the latest technology to view your liver and surrounding organs. Liver imaging tests include ultrasounds and cholangiograms (X-rays that use an injectable dye). We may also perform a hepatobiliary scan, a type of nuclear medicine test, to track bile flow from the liver.
  • Liver biopsy: Our doctors use a thin needle to remove a tissue sample from the liver. A liver biopsy helps diagnose liver disease and liver damage.
  • Physical examination: A pre-transplant physical examination includes screenings for cancers and transmittable diseases, dental examinations and heart and lung tests.
  • Psychosocial evaluation: This assessment ensures patients have the support and financial resources they need to recover from a liver transplant.

Next steps to liver transplantation: MELD score

We place you on the United Network for Organ Sharing (UNOS) national liver transplant waitlist if you’re a transplant candidate. UNOS bases the medical urgency of a liver transplant on a patient’s Model for End-Stage Liver Disease (MELD) score.

Blood tests determine this score. MELD scores range from 6 (least sick or least in need of a transplant) to 40 (most sick or urgent need for a transplant). Your score can change over time as your health worsens or improves. Our liver transplant team performs regular blood tests to recalculate the MELD score.

Patients with liver cancer or rare forms of chronic liver disease may need transplants more urgently than their MELD scores indicate. We have great success getting exception scores for people who need them. These scores replace the MELD score to qualify severely ill patients for transplant priority.

Find out what to expect during liver transplantation.

MELD scores and living donor liver transplants

If you have a lower MELD score, you may get a living donor liver transplant with us sooner. Our liver transplant program is one of a select few in Florida transplanting livers from living donors.

A living organ donor can help you get a transplant while you’re still in relatively good health. Patients who receive an earlier liver transplant tend to have fewer post-transplant complications.

Learn more about our living donor programs.

Help for patients with alcohol-related liver disease

We offer help and hope for people with alcohol-related liver disease who need liver transplants. Some centers require patients with alcohol use disorder to stay sober for at least six months before transplant consideration.

Our liver transplant team takes a different approach. We partner with behavioral health specialists at Cleveland Clinic in Florida to evaluate each patient’s risk factors. We may place patients on the transplant waitlist before they achieve six months of sobriety. This only happens if a patient’s assessment indicates a low to moderate risk of resuming alcohol use after transplantation.

We connect patients with the treatments and support services they need to achieve and maintain sobriety. High-risk patients may qualify for a transplant after they successfully complete a treatment program.

What to Expect

What to Expect

Our Transplant Center is one of a select few in Florida offering liver transplants from living and deceased donors. Our dedicated transplant nurse coordinators and living donor coordinators provide guidance throughout this complex transplant journey.

Liver Transplant Next Steps at Cleveland Clinic in Florida

Our liver transplant candidates may expect these next steps:

Placement on the national liver transplant waitlist

We place qualified patients with chronic liver disease or liver failure on the United Network for Organ Sharing (UNOS) national waitlist. Our team uses blood tests to calculate a Model for End-Stage Liver Disease (MELD) score. UNOS uses this score to prioritize the liver transplant waitlist.

A MELD score on the higher end (up to 40) indicates an urgent need for transplantation. The lowest MELD score, 6, indicates less urgency. You’ll get ongoing blood tests to see if the MELD score changes.

Living liver donor screenings

Family members and friends may choose to donate part of their liver to you. The donor’s liver will grow back (regenerate) to its usual size in a few months. Your transplanted liver segment will also grow to fit your body size. Our living donor coordinator helps facilitate the liver donation process.

All potential living donors get extensive physical and psychosocial assessments. A critical first step is seeing if the donor’s and patient’s blood types are compatible. If they’re not, other options are available through our living donor programs.

We still place you on the national waitlist. You may need a whole liver instead of a segment if liver disease becomes severe. Some living donors are unable to complete the donation process. There’s also a chance that you’ll get a liver from a deceased donor first.

Learn more about living liver donors.

Liver disease treatments

Until a transplant takes place, experts at our Center for Liver Disease provide comprehensive treatments for common to complex liver conditions. Our team works closely with your primary physician while providing pre- and post-transplant care.

Cleveland Clinic in Florida is also home to South Florida’s only multidisciplinary Liver Tumor Clinic.

Convenient liver function tests

We regularly give liver function tests to monitor disease progression and recalculate the MELD score. You may move up on the waitlist if your health worsens.

We make it easy for you to get liver function tests and pre-transplant care. You may continue to get some tests with your primary physician. We stay in continuous communication with your doctor.

Preparing for a Liver Transplant

A living donor liver transplant offers the benefit of knowing when surgery will happen. If you’re waiting for a deceased donor liver, you’ll hear from our transplant nurse coordinator when an organ is available. You should follow their instructions about the next steps.

After you arrive at our Transplant Center, you’ll get a physical examination, chest X-rays and an EKG (heart test). A blood test confirms that you and the donor are a good match.

Find out what to expect during post-transplant recovery.

Types of Liver Transplants

Types of Liver Transplants

The Cleveland Clinic in Florida Transplant Center offers all types of liver transplants, including living donor liver transplants. Our patient survival rates closely align with national averages, depending on the transplant type.

Our team’s liver transplant experience enables us to accept more donor livers. You may benefit from a shorter wait for transplantation. We consider many factors when deciding the type of liver transplant for each patient.

Living donor liver transplants

As one of the state’s few providers of living donor liver transplant services, we can do transplant surgery before you become seriously ill. A family member, friend or stranger may volunteer to donate a liver segment to you. A patient who is healthier and stronger at the time of surgery may recover more easily.

Learn more about living liver donors.

Deceased donor liver transplants

Most livers for transplantation come from deceased donors. A person may agree in advance to donate their organs when they die. Family members may also make this choice for a deceased loved one. Patients on the national transplant waitlist are waiting for a liver from a deceased donor. Unfortunately, waitlist patients exceed the number of available livers.

How urgently a person needs a transplant affects waitlist placement and wait time. Someone with life-threatening liver failure may get a transplant in less than 30 days. But some people wait five or more years for a liver from a deceased donor.

A living donor liver transplant can speed up the transplant process. But some patients need full livers or don’t have living donors. At the Cleveland Clinic in Florida Transplant Center, we’re taking innovative steps to help our patients get the lifesaving liver transplants they need.

Expanded criteria donors

We accept livers from expanded criteria donors (ECDs) to help more of our patients get donor livers. Our transplant team evaluates each liver before transplantation. We only transplant when tests show good liver function that will benefit a patient.

Most livers come from people who are younger than 70 (standard criteria donors). Expanded criteria liver donors are older than 70. Because the liver has the unique ability to regenerate, it’s possible to transplant livers from older donors safely.

Safe transplantation from high-risk donors

In the past, doctors couldn’t transplant livers from people who died of drug overdoses. The organs often had infectious diseases like hepatitis C. This virus can enter the bloodstream through infected needles and spread through contact with contaminated blood.

Cleveland Clinic liver transplant surgeons are national leaders in the safe and successful transplantation of hepatitis-positive livers into disease-free patients. Our doctors played key roles in developing a drug protocol that cures hepatitis after transplantation. Organ recipients take antiviral medications before and after transplant surgery.

Today, more than 1 in 8 donor organs come from overdose deaths. These organ donors tend to be younger with healthier livers. We always get a transplant recipient’s consent before using a hepatitis-positive liver.

Studies show that these liver transplants are safe for transplant recipients. The livers work as well as other donor livers. Patients also get donor livers faster, sometimes within weeks of consenting to a hepatitis-positive organ. They go on to lead a hepatitis-free life with their donor liver.

Some donors may have increased disease transmission risk for reasons unrelated to drug use. Our doctors are experts in safely matching these donor livers to consenting recipients. This strategy can shorten your wait time while providing excellent transplant outcomes.

Liver perfusion

Donor livers traditionally come from people who experience brain death from a brain injury, stroke or other issue. Their beating hearts continue to send oxygen-rich blood to organs. However, there’s no brain activity or chance of recovery.

Our liver transplant team is at the forefront of technology allowing successful transplantation of donor organs after circulatory death. Organ donation surgery takes place after a donor’s heart stops beating (sometimes called cardiac death). Cell damage can eventually occur in organs due to lack of blood flow.

At Cleveland Clinic in Florida, we use innovative machine perfusion methods to minimize this damage. Normothermic machine perfusion (NMP) circulates warm, oxygen- and nutrient-rich blood and fluids through the donor liver before transplantation. Cleveland Clinic liver transplant teams in Florida and Ohio were active in developing NMP. We have one of the largest volumes of NMP liver transplants in the country.

Machine perfusion also allows our team to test liver function before transplantation. When necessary, we perfuse the donor liver for several hours to improve liver function. Research suggests that perfused donor livers may work better and increase the chances of a successful transplant. Our teams also use machine perfusion to allow transplantation of other nonstandard and extended criteria donor livers.

Our South Florida liver transplant team also leads a hypothermic oxygenated perfusion (HOPE) national clinical trial. A machine circulates a cold, oxygenated solution through the liver before transplantation. Our Florida and Ohio transplant centers are two of only 15 centers nationwide participating in this clinical trial. We’re among a select few centers that have experience with both machine perfusion methods.

Split-liver transplants

A split-liver transplant helps two people get a liver transplant from one donor liver. Surgeons divide the liver into two sections. An adult receives the larger liver section, while the smaller segment goes to a small-sized adult or child. A split-liver transplant can save two lives and move two people off the transplant waitlist.

Multi-organ transplants

Some conditions damage multiple organs like the liver, kidneys, heart, intestines or pancreas. Our transplant teams are among a select few nationwide with the expertise to successfully transplant multiple organs during one surgery.

Our liver transplant team partners with surgeons from our Heart Transplant Program and Kidney Transplant Program. When appropriate, we collaborate with transplant surgeons from Cleveland Clinic in Ohio who specialize in multi-organ transplants.

Multi-organ transplants we offer include:

  • Liver and heart transplants.
  • Liver and kidney transplants.
  • Liver and intestine transplants (currently done in Ohio only).
Living Liver Donors

Living Liver Donors

Our Transplant Center is one of a select few in Florida where patients can get a living donor liver transplant. Approximately 1 in 5 of our patients benefit from this transplant option.

Living Donor Liver Transplants at Cleveland Clinic in Florida

Your liver has the amazing ability to grow back or regenerate. It’s the only organ that can do this. Regeneration allows adults to donate as much as half of their liver to someone in need. The donor’s remaining liver segment and the transplanted liver segment grow to normal size in three to four months.

We still place you on the national liver transplant waitlist even if you have a living donor. If liver disease becomes too severe, your body won’t be able to regenerate a partial liver. You’ll need a whole liver from a deceased donor. Some potential living donors are unable to donate or they change their minds. Placement on the transplant waitlist keeps all options open.

Benefits of living donor liver transplants

People who choose our liver transplant program benefit from:

Reduced wait for a liver transplant

It can take five years or more for a patient on the national transplant waitlist to get a liver from a deceased donor. (People with life-threatening needs may get donor organs sooner.) A patient’s health can decline while they wait for a transplant. A living donor liver transplant can happen as soon as the donor gets the medical OK.

Healthier donor livers

People who volunteer to be organ donors tend to be younger and in better overall health than deceased organ donors. Studies suggest that living donor liver transplants offer better three-year patient survival outcomes and fewer complications.

Shorter time from donation to transplantation

Donation and transplantation procedures take place on the same day at our Transplant Center. There’s minimal risk of tissue damage because the liver is out of a person’s body for a short time.

Decreased risk of organ rejection

A donor liver from a relative is usually a better match than a liver from an unrelated donor. Often, this means less risk of organ rejection and a greater chance of long-term transplant success.

Donating a Liver at Cleveland Clinic in Florida

A living donor liver transplant is relatively safe. Still, asking someone to undergo major surgery and give away part of an organ can be difficult. Our living donor coordinators help you identify potential living donors and engage them in this challenging conversation.

An independent donor advocate supports the donor throughout the process. Their top priority is the donor’s safety and well-being. Potential liver donors undergo extensive physical and psychosocial evaluations before surgery. Learn more about these tests and our living donor programs.

Recovery after liver donation surgery

Liver donors may spend a week recovering in the hospital. Before discharge, we ensure donors and their caregivers have the information necessary for a safe recovery.

We provide instructions about:

  • Caring for the surgical incision.
  • Signs of infection.
  • Medications, such as pain relievers and infection-fighting antibiotics.
  • Potential medication side effects.
  • Managing postsurgical issues like pain, constipation or bloating.
  • Activity limitations, such as not driving for two to four weeks.
  • Resuming most everyday activities in about eight weeks.

Life after liver donation surgery

A donor’s liver segment grows to its previous normal size in three to four months. Most donors don’t have dietary or activity restrictions. However, our transplant team monitors a donor’s health for two years after donation.

Donors may have follow-up tests at one of our Cleveland Clinic in Florida locations or with their primary physician. These may include blood tests, imaging tests and physical exams. Our transplant team makes sure the donor’s primary physician has the information needed to care for the donor after donation surgery.

Become a Living Liver Donor

To learn more about living liver donation:

Post Transplant Recovery

Post Transplant Recovery

Every patient’s recovery after a liver transplant is unique. Your recovery depends on your age, health at the time of transplant and other factors. Our liver transplant team ensures you have the care, resources and support for a successful return to everyday life.

After a Liver Transplant: Next Steps

You continue receiving the world-class care Cleveland Clinic is known for during your recovery. Our transplant nurse coordinators can help you at any time.

Here’s what you can expect after a liver transplant:

Inpatient recovery after a liver transplant

You may spend several days in the Transplant Center recovery unit. When your surgeon gives the OK, we’ll move you to a room in our Transplant Special Care Unit.

You may have:

  • Inflatable devices on your legs (intermittent pneumatic compression) to prevent blood clots.
  • Nasogastric tube in your nose to drain stomach secretions for a few days.
  • Sore throat from having a breathing tube in place during surgery.
  • T-tube to drain bile into a bag while the bile ducts heal.
  • Urinary catheter (flexible tube) that empties urine into a bag outside your body.

Going home after a liver transplant

Most people go home within 10 days after surgery, but discharge times vary. Our team makes sure you and your caregivers are comfortable caring for your health before you leave our Transplant Center.

We provide you and your caregivers with information about:

  • Caring for the incision and T-tube.
  • Warning signs of infection, organ rejection and medication side effects.
  • Taking pain medications and immunosuppressants to prevent organ rejection.
  • Monitoring and recording blood pressure, glucose levels, weight and temperature.
  • Dietary recommendations, such as following a low-fat, low-cholesterol diet.
  • Activity limitations, such as not driving or lifting heavy objects until your surgeon gives the OK (usually six weeks after surgery).

It can take several months to recover fully from liver transplant surgery. It’s normal to have pain, itching or numbness around the incision area while it heals. Most people return to work and everyday activities within six weeks after transplantation.

Convenient post-transplant care

You need biweekly and then weekly lab tests for the first two months after a liver transplant. These tests help our team detect early signs of organ rejection and start immediate treatments. When your results look good and are stable, you’ll switch to monthly and then annual checkups.

Our transplant team is in continuous contact with your referring physician throughout the transplant process. You may choose to get follow-up tests and care from your primary physician after our transplant surgeon clears you.

Appointments & Locations

Appointments & Locations

Patients and referring physicians may access our dedicated Transplant Center phone line at 954.659.6750 or email transplantfla@ccf.org.

You may get liver transplant and liver disease care at one of our convenient Florida locations:

Our liver transplant program also offers:

Our Doctors

Our Doctors