Skip Navigation
Miami Transplant Institute

Liver Transplant

Last Visited »

There are many important things to consider when selecting a liver transplant center, including experience, survival rates, program longevity, participation in research, and physician and staff credentials.

The Miami Transplant Institute is considered one of the leading transplant centers in the world with a major role in liver and intestinal/multivisceral transplantation.

In 2010, MTI received national recognition for extraordinary performance from the U.S. Department of Health and Human Services.

The liver transplant program was one of only a few transplant programs in the United States to be recognized at the Bronze level of Service.

The awards are presented by the Donation and Transplantation Community of Practice, which was established in 2003 by HHS to ensure best practices at all hospitals performing transplants. The awards are based on performance in three categories: graft survival one year after transplant, transplant rate, and mortality rate after being placed on the transplant list.

MTI is a collaborative endeavor between University of Miami Health System/Leonard M. Miller School of Medicine and Jackson Memorial Hospital.

MTI performs approximately 120-140 liver transplants per year and 15-25 intestinal/multivisceral transplants. A multidisciplinary team of medical professionals and patient advocates work together to increase access to transplantation and improve quality of life.

Criteria for Kidney Transplantation

At MTI, you will become partners with your health care team, which consists of s transplant surgeon, transplant nephrologist, transplant nurse coordinator, social worker, pre-transplant secretary, donor team, patient financial services, dietician, and psychologist. Everyone will work together to ensure a successful procedure and good long-term outcome.

The average waiting time for MTI liver transplant patients to receive their new organ is one year for a patients with a MELD score of 15 and usually 2-6 months for those with a MELD of greater than 20; shorter than most centers.

Intestinal/Multivisceral Transplant Candidate Criteria

Indications for Transplant

A selection committee composed of transplant surgeons, hepatologists, nurse coordinators, psychiatrists, social workers, dietitians and other interested individuals meets weekly to determine the suitability of potential liver transplant candidates and determine the timing and
priority for transplantation. General indications for intestinal/multivisceral transplantation are as follows:

  • Intestinal transplantation as isolated or in combination with liver or liver plus other viscera (multiviseral) transplantation is a therapeutic option for patients with irreversible intestinal failure.

Factors that are listed below are often the precipitating reason for proceeding with intestinal transplantation:

  • Complications related to TPN leading to liver failure
  • Lose of venous access (thrombosis of veins)
  • Frequent central line infections causing sepsis and requiring hospitalization for intravenousantibiotics or antifungal medications
  • Frequent episodes of severe dehydration despite intravenous fluid administration in addition to parenteral nutrition

Indications:

  • Gastroschisis
  • Volvulus
  • Necrotizing enterocolitis
  • Intestinal atresia
  • Chronic intestinal pseudo-obstruction
  • Microvillus inclusion disease
  • Megacystic mircrocolon
  • Multiple polyposis
  • Hirschsprung’s disease
  • Mesenteric – complete venous or arterial thrombosis
  • Crohn’s disease
  • Desmoid tumor with intra-abdominal infiltration
  • Trauma (multiple resections / explorations and vascular abdominal trauma SMA/SMV injuries)
  • Other: ___________________________________________ (specify)

Contraindications:

  • Systemic active sepsis
  • Multiorgan failure
  • AIDS
  • Carcinoma with metastasis (except neuro-endocrine tumors, even in the presence of metastasis may undergo multiviseral / cluster transplantation)
  • Severe cardiovascular and respiratory instability and psychosocial instability
  • Severe pancreatitis
  • Severe cerebral edema
Back to Top

Referral Process

All referrals must come from a health care professional. Your primary care physician, gastroenterologist, hepatologist or insurance company may submit your referral.

Transplant referrals are made by health care professionals. You may also download the physician referral form to give to your primary care physician or gastroenterologist for completion.

Once your referral has been forwarded to our center, you will be processed for financial clearance. Once cleared you will be given an appointment to meet with the surgeon and your pre-transplant coordinator.

We invite you to take the mandatory class. After completing the class, please download the test, complete, and bring to your first appointment. If you do not complete the class and test prior to your visit, you will be required to attend a scheduled class appointment.

Please take the time to review the following informative documents that will be discussed with you at your first appointment.

Contact us MTILiverinfo@med.miami.edu for more information, or call 305-355-5095 or 305-355-5160 from 8:30 a.m. to 4 p.m. EST.

Once you have completed all of the forms and collected the necessary medical records, you may e-mail the information to MTILiverinfo@med.miami.edu, fax it to 305-355-5790, or mail to:

Miami Transplant Institute
Liver/GI Referral Area
1801 NW 9th Avenue, Third Floor
Miami, FL 33136

Back to Top

Initial Appointment

Once your completed referral has been received the wait time until your initial appointment varies depending upon your insurance plan. If your carrier is contracted with the University of Miami Health System and Jackson Health System, an MTI representative will contact you to go over the referral and issue an appointment and class date. If your insurance carrier is not contracted with MTI, your referral will need approval from the MTI Finance Team before making an appointment.

You will need to bring any diagnostic testing results (ultrasounds and x-rays) done in the last six months that have not be previously sent to us including the CD’s of the x-rays. If you are over 50, you should bring your most recent colonoscopy results, including the pathology report. If you are a woman over 25, you should bring the results of your last pap smear, and if you are over 40, your last pap smear and mammogram reports. All patients will need to bring a clearance note from the dentist within the last year.

During your first appointment with the Transplant team most patients will meet with surgeon and pre-transplant coordinator and have labs drawn to determine how quickly your work up needs to be done. Subsequent visits will including meeting with the hepatologist, social worker, dietician, anesthesiologist and psychiatrist if needed.

Please bring:

  • Any additional medical records and testing done by Gastroenterologist, Hepatologist, or PCP
  • Copies of driver’s license and all insurance cards
  • A sweater
  • A snack

Appointment may last hours.

Your evaluation will consist of the following tests:

  • Doppler ultrasound of the liver
  • Triple phase CT of the abdomen
  • Cardiac evaluation (annual) including an EKG, dobutamine stress echocardiogram, possible cardiac catherization and cardiology clearance
  • Chest x-ray (annual)
  • EGD
  • Colonoscopy if you are greater than 50 years old
  • TB test (annual)
  • Immunizations – Pneumovax (good for 5 years), Hepatitis A and B vaccine (if you don’t have antibodies against them), Influenza
  • Gynecological evaluation – PAP smear and mammogram
  • Dental evaluation (annual)
  • 24 hour urine collection for creatinine clearance and protein
  • Any other testing/consults as directed by your past medical history

Diagnostic testing can be done locally or will be arranged by the Transplant Center to be performed at UM/JMH.

Back to Top

Transplant Options

  • Living Related Donor (LRD)
  • Living Unrelated Donor (LURD)
  • Living Paired Donor
  • Deceased Donor Waiting List

Once your referral is received and MTI contacts you, we will obtain any potential donor information. Please speak with your family and friends about their willingness to donate prior to providing their names to the MTI team. The potential living donor(s) will be directed to the Living Donor Program once we have completed the referral process.

Back to Top

Transplant Preparation

Accommodations near the medical campus:

Transplant House
Jackson Towers
1500 NW 12th Avenue, 7th floor West
Miami, FL 33136
Phone: 305-585-1500
E-mail: Dmiller3@med.miami.edu

Marriott SpringHill Suites Miami Arts/Health District
1311 NW 10th Avenue
Miami, FL 33136
Phone: 305-575-5300; toll-free 800-228-9290; fax 305-575-5301
Web: www.MiamiSpringHill.com

Should you require additional housing options, please discuss your needs with your transplant social worker.

  • Keep testing updated every 6 months
    • Doppler ultrasound of the liver
    • Triple phase CT of abdomen (this test is sometimes done every 3 months for some patients)
  • Annually
    • Cardiac – EKG, Stress test, Echocardiogram
    • Chest x-ray
    • TB
  • Visit transplant center every 6 months
  • Notify your transplant center if you are hospitalized
  • Notify transplant team of any changes in address, phone, insurance or travel
  • Notify transplant team of any changes in health or medical urgency issues

When you are called:

  • You may be called any time of the day or night.
  • Once called, you will have to go to East Tower Holtz Admitting office during working hours (7a-9p) or to the Emergency Room after hours. If you go to the Emergency Room let them know that you are scheduled for a transplant once you check in.
  • You may have multiple “dry-runs” before your actual transplant occurs.

Where to go:

Step 1 ADMITTING:

Once confirmed for transplant, proceed to Holtz admitting located at:
1611 NW 12th Ave
Miami, FL 33136
Parking is available at Park Plaza West. Follow side walk East and Northeast to Holtz admitting.

OR

To the Jackson Memorial Hospital Emergency Room located at:
1611 NW 12th Ave
Miami, FL 33136
Parking is available at Park Plaza West. Follow side walk East and Northeast to Holtz Admitting.

Parking located next door at:
Park Plaza West
1611 NW 12th Ave
Miami, FL 33136
Accessible through NW 12th Ave and NW 16th Street

Step 2 ABDOMINAL TRANSPLANT FLOOR:

Once admitted, exit Holtz and enter main hospital to the right in the West Wing. Access elevators to the 15th floor and proceed down hallway to nurses station to check in.

Step 3 OPERATING ROOM

You will be transported to the operating rooms located in the Diagnostic Treatment Center.

View Map

What to bring:

  • List of meds
  • Essential toiletries
  • PD Supplies
  • If you need financial assistance, bring copy of income tax papers

Don't bring:

  • Valuables
  • Plants or flowers
  • Visitors under the age of 14 years
Back to Top

Your Transplant

Surgery time:

  • Liver 6-10 hours
  • Intestine 6-12 hours
  • Multivisceral 10-16 hours

Time in hospital:

  • Discharge teaching will begin from time of admission for transplant and have support system available
  • Discharge when medically stable, even if you may not feel ready, usually in 3-4 weeks after surgery

Will your new organs work right away?
Most organs will work immediately. The motility of your intestine will begin to work as the anesthesia and pain medications wear off. It will be important for you to get out of bed and start to move around as soon as possible as this will help things start moving in the right direction. Once the intestine starts to work you will be allowed to have fluids to drink and eventually solid food. You will be continued on TPN until your oral intake is adequate enough to sustain you. Most patients will require intravenous hydration for some time after the transplant.

Back to Top

Post Transplant

Complications:

Rejection of the Intestines
Citrulline Education Infections

The ABC’s of CMV
Diabetes

GVHD (Graft Versus Host Disease)
PTLD (Post-Transplant Lymphoproliferative Disorder)

Outpatient Care:

Discharge Instructions
General Health Considerations
General Health Conditions

Care for Wounds
Discharge Medicine
Care of your Ostomy

Lab work:
Lab Work

Support groups:
Monthly Support Groups

Back to Top

Transplant Team

Surgeons:

Seigo Nishida, M.D. FACS

Professor of Clinical Surgery

Gennaro Selvaggi, M.D. FACS
Associate Professor of Clinical Surgery

Akin Tekin, M.D.
Assistant Professor of Clinical Surgery

Hepatology:

Dr Kalyan Ram Bhamidimari
Asistant Professor of Medicine

Paul Martin, M.D.
Professor of Medicine
Chief, Division of Hepatology

Cynthia Levy, M.D.
Associate Professor of Medicine

Christopher B. O’Brien, M.D.
Chief of Clinical Hepatology
Professor of Medicine
Division of Liver and GI Transplantation

Kalyan Ram Bhamidimari, M.D.
Asistant Professor and Medicine

Pediatric Gastroenterology:

Jennifer Garcia, M.D.
Assistant Professor of Clinical Pediatrics

Anesthesiology:

Ernesto A. Pretto,M.D.
Professor, Anesthesiology
Chief, Division of Solid Organ Transplant & Vascular Anesthesiology

Kyota Fukazawa, M.D.
Associate Professor of Clinical Anesthesiology

Vinaya Manmohansingh, M.D.
Assistant Professor of Clinical Anesthesiology.

Vadim B. Shatz, M.D.
Assitant Professor of Clinical Anesthesiology.

Todd J. Smaka, M.D.
Assistant Professor of Clinical Anesthesiology

Fouad G. Souki, M.D.
Associate Professor of Clinical Anesthesiology

Administration, Nursing, and Support Staff:

Scott Koonce, R.N., M.B.A.
Transplant Nurse Manager, Liver and GI
Skoonce@jshmiami

Pre-Transplant:


Orlando A. Granado-Balaez R.N.
Clinical Transplant Coordinator
orlando.granadobalae@jhsmiami.org
305-355-5758

Lauren Zartemi R.N.
Clinical Transplant Coordinator
lzartemi@jhsmiami.org

Karen McAlevey-Nordt R.N., B.S.N.
Clinical Transplant Coordinator
Kmcalevey@med.miami.edu
305-355-5762

Vivienne Maragh R.N.
Clinical Transplant Coordinator
Vmaragh@jhsmiami.org
305-355-5763

Post Transplant:

Yolanda Villasnor R.N., M.S.N.
Clinical Transplant Coordinator
Yvillasenor@jhsmiami.org
305-585-5729
Elizabeth Calibag R.N., B.S.N.
Clinical Transplant Coordinator
Ecalibag@jhsmiami.org
305-585-5725
Cassandre Oscar R.N., B.S.N.
Clinical Transplant Coordinator
Ocassandre@jhsmiami.org
305-585-5726
Elsie N. Saguinsin R.N., M.S.N., A.R.N.P.-B.C.
Clinical Transplant Coordinator
Esaguinsin@jhsmiami.org
305-585-5728
Linda Casale R.N., M.S.N., A.R.N.P.
Clinical Transplant Coordinator
Lcasale@jhsmiami.org
305-585-5706
Elmer Cacayorin R.N.
Clinical Transplant Coordinator
Ecacyorin@jhsmiami.org
305-585-5730
Bella G. Mendez R.N., B.S.N.
Clinical Transplant Coordinator
Bgleiser@jhsmiami.org
305-585-5724
Antoinette Demanno R.N, B.S.N.
Clinical Transplant Coordinator
Ademanno@jhsmiami.org
305-355-5722

Lynda Saintilnor (In Patient)
Transplant Coordinator
lsaintilnor@jhsmiami.org
305-585-8483

Pediatric:

Louise M. Cubley R.N., B.S.N.
Clinical Transplant Coordinator
Lcubley@jhsmiami.org
305-585-8574
Tangilar D. Dorsett R.N., B.S.N.
Clinical Transplant Coordinator
Tdorsett@jhsmiami.org
305-355-5738
Toni Behler, RN, BSN
Clinical Transplant Coordinator
TGarcia1@jhsmiami.org
305-585-8574

Social Workers:

Vevila S. Finch M.S.W.
Out-Patient Adult & Pediatric Liver/GI Transplant
Vfinch@jhsmiami.org
305-355-5792

Luis Moreno M.S.W.
Adult-In Patient Liver/GI Transplant
lmoreno@jhsmiami.org

Brenda Philips M.S.W.
Pedi-In Patient Liver/GI Transplant
bphilips@jhsmiami.org

Pharmacist:

Jennifer Jebrock, PharmD, BCPS
Liver & GI Transplant Clinical Pharmacist – Adult
Jennifer.Jebrock@jhsmiami.org
305.585.7350

Alexandra Centeno, Pharm D
Liver & GI Transplant Clinical Pharmacist
alxendra.centeno@jhsmiami.org
305-585-6544

Dietician:

Rocio Garcia, RD, LD/N
Registered Dietician – Adult
Rocio.Garcia@jhsmiami.org
305-355-5020

Back to Top
Miami Transplant Institute
ToolsFeedback