Before liver transplantation, the most important thing is to have a thorough medical evaluation of your physical status to understand whether you are eligible for liver transplantation.
In addition, patients must be adequately prepared psychologically and financially, arrange for themselves and their family members,
Laboratory tests
These medical tests include:
- Blood, urine, and stool routines;
- Liver and kidney function;
- Electrolytes (potassium, sodium, chloride, calcium, phosphorus, magnesium);
- Coagulation set;
- Glucose;
- Lipids;
- Transfusion-related tests: blood typing, hepatitis B and C virus markers, etc;
- Transfusion-related tests: blood typing, hepatitis B and C virus markers, etc;
- Transplant-related virology tests, such as cytomegalovirus, Epstein-Barr virus (EBV), etc;
- Tumor markers: methemoglobin, carcinoembryonic antigen, Ca19-9, abnormal thrombospondin, etc.
If available, polymorphisms in peripheral blood circulating tumor cells (CTCs) and CYP3A5 genes can also be tested in preparation for post-transplant immunosuppressive regimens.
Imaging
Imaging includes:
- chest radiograph or chest CT;
- Liver-enhanced MRI;
- CT angiography to clarify the hepatic artery, portal vein, hepatic vein, and inferior vena cava;
- PET-CT (positron emission tomography-computed tomography) or PET-MRI to exclude extrahepatic metastases and to understand tumor activity;
- Electrocardiogram, cardiac ultrasound, and pulmonary function.
Other tests
Microbiology is feasible if the patient has a recent history of infection and is on antibiotics.
Anti-tumor therapy
In addition to the necessary preparations mentioned above, while waiting for transplantation, patients with liver cancer should undergo anti-tumor therapy, such as radiofrequency ablation, interventional chemotherapy, and targeted therapy, under the guidance of their doctors to control tumor growth.