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Pre-liver transplantation evaluation

Pre-liver transplantation evaluation
Laboratory testing
ABO-Rh blood typing
Liver biochemical and function tests (ALT, AST, alkaline phosphatase, bilirubin, INR)
Sodium 
CBC with differential
Creatinine clearance
Serum alpha-fetoprotein
Calcium and vitamin D levels
Serologies for CMV, EBV, varicella, HIV, HAV, HBV, HCV, RPR
Urinalysis
Urine drug screen
Cardiopulmonary evaluation
ECG
Cardiac stress test (exercise or pharmacologic) if over the age of 40 years or if there are multiple risk factors for coronary artery disease (followed by cardiac catheterization if positive)
Contrast-enhanced echocardiography
Pulse oximetry
Arterial blood gas
Chest radiography
Contrast-enhanced chest CT
Pulmonary function tests with DLCO
Cancer screening
Contrast-enhanced abdominal CT scan or MRI to look for hepatocellular carcinoma
Skin examination
Colonoscopy (if indicated based on patient's age or risk factors)
Cervical cancer screening and breast cancer screening for women (if indicated based on patient's age)
Prostate cancer screening for men (if indicated based on patient's age)
Infectious disease evaluation
Skin testing or interferon-gamma release assay for tuberculosis
Dental evaluation
Screening for coccidioidomycosis or strongyloides (for patients from endemic areas)
Psychosocial evaluation
Psychiatric evaluation
Social work evaluation
Patient education seminars
Evaluation for substance use disorders (drugs or alcohol)
Other testing
Bone density scan
Transabdominal ultrasound with Doppler imaging to assess the hepatic vasculature (if not already assessed with cross-sectional imaging)
Upper endoscopy in patients with cirrhosis or portal hypertension
ALT: alanine aminotransferase; AST: aspartate aminotransferase; CBC: complete blood count; CMV: cytomegalovirus; CT: computed tomography; DLCO: diffusing capacity of the lungs for carbon monoxide; EBV: Epstein-Barr virus; ECG: electrocardiogram; HIV: human immunodeficiency virus; HAV: hepatitis A virus; HBV: hepatitis B virus; HCV: hepatitis C virus; INR: international normalized ratio; MRI: magnetic resonance imaging; RPR: rapid plasma reagin.
Courtesy of Lorna Dove, MD, MPH and Robert Brown, MD, MPH.
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