How, when, where do you start the liver transplant process?

@gently I live in a small town in New Mexico. Shes been to every emergency room here and they never knew what it was until recently. Its so hard to get an appointment with a specialist here end we dont hardly have any. They didnt tell us the levels or anything at all. Just if it gets worse to come back.

@shacquie, if your mom's doctor recommends a liver transplant, you may be referred to a transplant center. You're also free to select a transplant program on your own or choose a program from your insurance company's list of preferred transplant centers.

You can read more about the liver transplant process here: https://www.mayoclinic.org/tests-procedures/liver-transplant/about/pac-20384842

I moved both your discussions into one so that people can see more of you and your mom's story. I see that you are very worried about your mom. It must be hard to see her suffer and even harder to wait for an appointment to see the GI specialist. Thank goodness she was given lactulose by the ER doctor. It will lower the level of ammonia by increasing bowel movements. It also may improve the health of her gut, making recovery easier.

As @katebw suggests you might wish to stay close to your mom the next days until her appointment with the GI. As Kate and @gently said, don't hesitate to call the GI office to see if you can get an earlier appointment.

If you would like to seek the opinion of Mayo Clinic experts, I recommend calling them or using the online form to request an appointment. You can find the Arizona number or online form here: https://mayocl.in/1mtmR63

Does your mom live with you or near you?

@pgruetz the doctors here are very limited. Its such a small town, like maybe 25k people. They dont send the referrals and tales weeks before biopsies and things like that can be done. Im worried about waiting 10 more days to see the gastrointestinal Dr. Then wait again for labs and images before anything is done. What are your thoughts?

@shacquie@shacquie Hi I would try to confirm something before hand before driving NM to AZ. Even if it is a small town doctors have a code they need to treat folks. Not sure if referrals per se are covered with that. I think Mayo would treat her but I think it's better to maybe call your Insurance folks or whatever Docs have already treated your Mom or Mayo. To firm something up. Glad you have an appointment with a Doc you mentioned in your other thread. If any Mayo Coordinators, Directors or Mentors see this thread they may have other/better suggestions. Hang in there.

@craigcraig we dont have much options here where I live in new mexico and I dont have anyone to help me with this. Its limited as far as doctors, care, Specialists. It could take weeks before even seeing one. Meanwhile her belly is bloated. The lactulose makes her pee alot but she's not really eating so she doesn't poop. I feel lost and confused and like time is of the essence but I dont know where to go now. Im only 6 hour drive from the mayo emergency room in Phoenix. Thoughts?

First step is your doctor to lead you to a specialist, there are many factors are you taking drugs or drinking most places want zero use for a year no smoking is recommended and depending the condition of the liver is . I have heard of people getting one in 2 months it took me 7 months. My advice is be in really good shape before you have the surgery, I didn’t have that option. This is a great site to get advice and recommendations stay healthy

If someone really needs a liver transplant there are a lot of tests that need to be done first to determine how bad the liver function is and if there are other health factors that need to be addressed. Scheduling the tests and getting them done took 2-3 months. It felt like a full time job. I started the process in February of 2025 and had the transplant eight months later. I believe that is a lot quicker than most but I had a somewhat rare condition of Hepatopulmonary Syndrome.

@ajdo129 I agree with all these folks. While on medical stuff we need to represent ourselves and know what's going on I think for this your local doctor / insurance co needs to coordinate with Mayo on the steps needed to try to get you on the list. To much detailed and specific requirements for a layman to do on our own. After my liver cancer diagnosis my insurance co & local doctors had me go through about 3 months of testing + one trip to AZ before I was added to the Mayo list. All coordinated by local Drs + Insurance folks + Mayo. And then was very lucky to get the transplant in less than a month. Usually takes months or even years for some folks. Best of luck.

Shacquie, how how were her ammonia levels?
If you don't have the full report from emergency, call their records office tomorrow and request them.
https://www.mayoclinic.org/tests-procedures/living-donor-liver-transplant/pyc-20384846.

Hi to all. I am brand new at this. I imagine its difficult to get approved for a liver transplant and of course harder to find one. Does anyone know how or where or when to start? Is there a best way to qualify and actually get one? I greatly appreciate any comments form anyone. Anything helps