UCSF Liver Transplant Program
The UCSF Liver Transplant Program began in 1988 and has since performed more than 3,000 liver transplants. The U.S. Department of Health and Services has designated the UCSF program as a “Center of Excellence” and the UCSF department performs more transplant surgeries than any other hospital in Northern California. In fact, the one year survival success rate at UCSF liver transplant center is on average higher than the national standard provided by the Scientific Registry of Transplant Recipients (SRTR). The BIE team recently had the opportunity to visit UCSF Parnassus and shadow Dr. Danielle Brandman, MD, MAS, Assistant Professor of Medicine in the Hepatology and Liver Transplantation department.
On our visit, we learned extensively about end stage liver disease and the procedures and restrictions involved with the liver transplant waiting list. Currently, there is no cure for end stage liver disease with the exception of liver transplants. In the US, the demand for viable livers significantly outweighs the supply. There are over 16,000 Americans still waiting for a liver transplant. Each year over 3,000 Americans are removed from or die while waiting for a liver transplant. The Model for End-Stage Liver Disease (MELD) score determines the priority for the waiting list. However, severe, acute changes to a patient’s health can significantly change the MELD score, and in some cases, disqualify patients from remaining on the waiting list. In addition, due to the priority assignment, most liver transplant patients are severely ill and may die before being able to undergo surgery. Since maintaining the waiting list for liver transplants is challenging and complicated, the BIE team was able to identify several needs related to the efficiency and efficacy of the waiting list.
Dr. Brandman also showed us the different facilities of the Liver Transplantation Program, leading us through a day in the life of a liver transplant patient. We were able to meet with pre-transplant coordinators, nurses, social workers, and surgeons involved in the liver transplant process. We visited Dr. Brandman’s clinic and learned about the electronic medical records system and how UCSF works towards making sure every patient’s experience is positive. We also observed a colonoscopy and visited the ICU and interventional radiology department during our time there. Overall, visiting the UCSF Liver Transplant program was a great learning experience for the BIE team to gain perspective about the complex problems that patients suffering from end stage liver disease face.
