Liver Transplant Team
The following is a description of liver transplant team members who will care for you before, during and after your transplant.
Surgeon
The transplant surgeon performs your liver transplant and helps guide you through recovery.
Following your surgery, you will wake up in the medical-surgical intensive care unit (MSICU), a specialized area of the hospital where close monitoring is in effect for 24 hours. The surgeon, along with your hepatologist and ICU team, monitors your vital signs and the function of your transplanted liver to ensure it is working properly. Additionally, they decide what medications you'll take and observe your wound to see that it is healing as necessary.
Hepatologist
Just as before surgery, the hepatologist continues managing patients' medical care following transplantation. The hepatologist and surgeon guide the transplant team through your recovery and monitor any possible rejection or infection of your new liver. To help prevent rejection, the hepatologist and surgeon will determine what immunosuppressive medications you need. Your hepatologist and surgeon will also oversee your post-transplant follow-up care and examine you at clinic appointments once you are discharged from the hospital.
Anesthesiologist
The anesthesiologist administers a general anesthetic prior to your liver transplant surgery and monitors your heart and lung function throughout the operation. In addition to the anesthetic, a central line is placed into one of your large veins at the time of surgery. The catheter is used for administering medications, monitoring pressures and retrieving blood for laboratory tests directly from your circulatory system.
Hospitalist
The hospitalist provides day-to-day management of patients in the hospital, both before and after liver transplantation and works closely with the transplant surgeon and hepatologist to deliver care.
Physician Assistant
The physician assistant is a healthcare professional who assists the physician with patient care. His or her primary role is to assist with the liver transplant operation and post-operative care of transplant patients.
Transplant Nurse Coordinators
The transplant nurse coordinators are in charge of coordinating all aspects of the transplant process, including your pre-transplant evaluation, transplant hospitalization and post-transplant follow-up. Their many responsibilities include patient and family education throughout the entire transplant process and ongoing communication. The transplant coordinators are also involved in the organ procurement and retrieval process, as well as community and professional education. They are an integral part of the transplant team and work very closely with all of your physicians including your referring doctor, the transplant surgeons and your hepatologists.
In addition to the transplant nurse coordinator, an inpatient transplant nurse coordinator will teach you about your immunosuppressive medication and post-transplant care prior to your discharge from the hospital. You will also review this discharge guide with your inpatient coordinator, who will help ensure you understand how to care for your new liver.
Staff Nurse
The hospital's staff nurses are responsible for coordinating the efforts of all your caregivers. Since nurses spend the greatest amount of time with you during your stay, they are in the unique position to evaluate your well-being, meet your immediate needs and act as a link among the various team members. They are available to provide a range of services, interventions and expertise, and to represent your best interest.
The nursing staff is committed to keeping you well-informed about every aspect of your health care needs and emphasizes patient education. They offer instruction and information both formally and informally, and try to include your family or caregiver(s) in the learning process.
House Staff
California Pacific Medical Center is a teaching hospital. This means that interns, residents and fellows will follow your care along with your attending physician. Your intern, a physician in the first year of training after medical school, is responsible for the current and ongoing knowledge of your condition. The intern will examine you daily and present a summary of your status to your attending physician daily during rounds. He or she is also available to you and your nurses to discuss your daily care and progress. There is always an intern and resident available during the night. Even if the night doctor is not your regular intern, this physician has been fully informed of your case prior to taking "call" and is prepared to deal with any emergency situations during off-hours. Your attending physician or an associate is also available in emergencies.
Social Worker
The liver transplant social worker is part of the Liver Transplant Team and involved with you from the time of your initial evaluation. The social worker provides the team with a psychosocial assessment that includes a social history and assessment of the patient's and family's coping abilities, motivation, compliance and support system. Practical issues such as who will stay with you after discharge from the hospital and the availability of funds for living expenses while in San Francisco are assessed. When necessary, the social worker can offer suggestions about how to initiate fundraising.
The social worker provides counseling and emotional support to both you and your family, from the time of evaluation through post-discharge. Additionally, a Liver Transplant Support Group, facilitated by the social worker, provides both inpatients and outpatients with a comfortable place to share questions, concerns and experiences. The support group is not a classroom situation, but rather an opportunity to share feelings and emotional experiences with others who have gone through a similar crisis.
Throughout the transplant process, the social worker advises about practical problems such as local lodging, transportation, insurance, financial concerns and referrals to
Medi-Cal and State Disability.
Clinical Dietitian
A registered clinical dietitian evaluates your nutritional status and helps with any related problems. If your appetite is poor, the dietitian will provide you with nutritional supplements to increase your caloric intake. Prior to discharge, the dietitian is available for nutrition information and counseling. If you are on a special diet, written information will be provided to assist you in the transition from hospital to home.
Psychiatrist
It is not uncommon for patients with liver disease facing a transplant or those who have already undergone transplantation (or their families) to have difficulty in dealing with their hospitalization and/or illness. When this occurs, a consultation with the psychiatrist may be requested by the patient or transplant team member. These consultations not only assist the patient and family in dealing with their feelings, but also help the hospital staff to better understand what the patient is experiencing.
Physical Therapist
An exercise program, varied according to each individual's condition and needs, is an essential component of your recovery. The program is one of steadily increasing activity in preparation for discharge. Progressive exercise programs are supervised by a registered physical therapist. If necessary, a physical therapy program may be continued in the outpatient setting. This will be arranged prior to your discharge.
Chaplain
The chaplain provides direct pastoral care for patients' and families' spiritual needs. This may be done by incorporating prayer, scripture and sacraments while respecting your religious traditions.
Financial Counselor
The financial counselor is available to assist you with questions concerning your medical insurance coverage and to offer financial guidance for your hospital stay.