Liver Transplant Referrals
Referrals
If you are interested in having an evaluation to determine if you are a potential transplant recipient, you, your physician, or any other caregiver may contact the program.
Referring providers who have questions about referring a patient who may be a potential liver transplant candidate can call (608) 263-9531 and ask to speak to one of the liver transplant coordinators.
Referring providers will be asked to provide the following information about the patient when calling to make a referral: name, address, phone number, date of birth, social security number, disease, primary doctor, insurance, and if the patient has received a transplant previously.
After the initial referral call, providers will be asked to forward the following patient records, if available:
- Current history and physical
- Summary letter of patient's medical condition
- Current Labs
- Abdominal CT scan report
- Liver biopsy report
- Cardiac tests including, ECG, Echo (tape), stress test
- Medication list
- Most recent discharge summaries
- Mammogram, pap and pelvic exam results for females
- Documentation of cancer diagnosis
- Colonoscopy report (if done within past three years)
- Advance directives or living will
- Chest X-ray report
