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About the Program

Massachusetts General Hospital and Brigham and Women’s Hospital have a rich history in performing and pioneering organ transplant procedures, and our transplant programs are among the longest-standing and most well-regarded in the country. In 1954, the very first successful organ transplant in the world was performed at Brigham and, in the years that followed, both institutions led a series of groundbreaking transplant firsts. Since 1988, Mass General has been at the forefront of liver transplant, performing more than 1,000 liver transplants to date, making it the most experienced liver program in New England.

In 2021, Mass General and Brigham united to develop the joint Mass General Brigham Liver Transplant Program. The goal of this collaboration was to expand care options to our patients and combine the extensive liver care and organ transplant knowledge of our two institutions. Our liver transplant team—made up of medical and surgical doctors from the two highest-rated hospitals in New England—provides complete treatment, transplant and management options for patients with acute or chronic liver disease, as well as patients with liver cancer.

Expanded Care at Mass General & Brigham

The Mass General Brigham Liver Transplant Program is comprised of both Mass General and Brigham clinicians. Through this collaboration, you have the option to be seen by doctors at either of the Boston locations for:

  • Evaluation, which can also be completed at an outreach evaluation clinic
  • Navigation of the transplant waitlist
  • Post-transplant care

Surgical care will be solely performed at Mass General. Once you start your care at either Mass General or Brigham, your ongoing liver disease management will be maintained at that same institution.

Benefits of Multi-institutional Care

The Mass General Brigham Liver Transplant Program offers you the opportunity to receive expert care from a broader team of clinicians and additional locations for evaluation.

The Mass General Brigham liver transplant team collaborates very closely for every patient, so you will always benefit from the expertise of a network of providers from across the Mass General Brigham system, regardless of the location where you receive care.

Opportunity for Evaluation at Outreach Clinics

Patients who are seeking initial evaluation for liver care, but do not want to travel to Boston, can be seen by members of the transplant team at one of the two Mass General Brigham liver outreach evaluation clinics. These clinics are located at:

  • Cooley Dickinson Hospital in Northampton, MA
  • Wentworth-Douglass Hospital, Pease International Tradeport in Portsmouth, NH

Transplant Evaluation Process

At all of the locations where we offer transplant evaluation—Mass General, Brigham or our outreach clinics—you will receive integrated, comprehensive care, beginning with a careful assessment and discussion to ensure that transplantation is the best treatment option for you. You will work with a transplant coordinator, who participates in the initial evaluation, gathers medical information and previous test results, and manages your full treatment plan, which includes:

  • Medical diagnosis
  • Patient education and review of care options
  • Surgical and psychosocial evaluation
  • Other transplant-specific testing

To begin the liver transplant process, you or your physician should contact the Mass General Brigham Liver Transplant Program at 877-716-8440. You will be asked to provide your medical records. Once received, a liver transplant nurse coordinator and a transplant hepatologist will review your referral and medical records. Following this review, the Mass General Brigham transplant staff will then schedule an initial evaluation appointment.

Depending on the number of tests required for your case, the length of the evaluation process can vary. Our goal is to complete all testing within one month, except for patients in need of emergency transplantation, who are tested immediately upon hospital admission.

Part One: Initial Evaluation

You will begin the liver transplant evaluation at the Mass General Brigham Liver Transplant Evaluation Clinic. During the day you will:

  • Attend a liver transplant education session
  • Have blood testing done
  • Meet with all the members of the transplant team, including your individual nurse coordinator, hepatologist, surgeon, social worker, dietitian and financial coordinator
Part Two: Specialized Testing

After the initial clinic visit, you will return for additional testing and appointments as needed. The liver transplant team will assist you in scheduling these tests and appointments, which may include some of the following:

  • Cardiac stress testing
  • Chest X-ray and electrocardiogram (EKG)
  • Additional blood and urine tests
  • CT scan
  • MRI/MRA
  • Meeting with a pharmacist
  • Meeting with a psychiatrist
  • Meeting with the liver cancer team

You will be responsible for scheduling the following tests with your local doctor and/or providing recent results in order to complete the transplant evaluation. Due to the fact that patients start on immunosuppression at the time of liver transplant, up-to-date cancer screenings and dental exams are required, including:

  • Colonoscopy (age 50+)
  • Dental exam (within the past year), to ensure that there are no preexisting dental conditions that could lead to infection
  • Pap smear
  • Mammogram (age 40+)

You will learn more about immunosuppression at your evaluation visit.

Part Three: Review by Committee

Once testing is complete, the entire transplant team will meet to determine your candidacy for listing for liver transplantation. You and your referring physician will be informed of the committee’s decision within a few days after the meeting.

Liver transplant candidates are placed on the national United Network for Organ Sharing (UNOS) waiting list, which manages the distribution of organs nationwide.

Waiting List

If you are found to be a good candidate for liver transplantation, you will be placed on the Mass General Brigham Liver Transplant waiting list managed by the UNOS. UNOS is contracted by the federal government to manage the nation's organ transplant system.

Because there are many more people who need a liver transplant than there are deceased donor livers available, UNOS will rank you based on how sick you are, as measured by your Model for End-Stage Liver Disease (MELD) score. Certain patients are eligible for additional MELD points (called “exception points”) from UNOS, based on their disease. For example, patients with hepatocellular carcinoma (liver cancer) or hepatopulmonary syndrome (a lung condition caused by liver disease) may be eligible for additional MELD points.

Due to an inadequate supply of donor organs, many patients are very ill by the time they reach the top of the waiting list. However, there is a spectrum of quality of donor livers, some of which may not be taken by patients at the top of the list, but which might be appropriate for patients further down the list. Living donor liver transplantation is another option to expedite transplantation. For more information, please contact your transplant coordinator to make an appointment to discuss these options.

When a donor organ is available, you will receive a call from your coordinator or surgeon asking you to come into the hospital for the transplant. Since this call can come at any time during the day or night, any day of the week, it is important for the transplant team to be able to reach you promptly. You should provide our center with all of your phone numbers, as well as the phone numbers of a few emergency contacts, so that we can contact you when needed.

Collaboration with Liver and Cancer Centers

Specialists in the Mass General Brigham Liver Transplant Program work closely with their medical, surgical and oncological colleagues to ensure comprehensive and personalized treatment. This collaboration allows patients with liver disease and cancer to receive coordinated care that includes the most advanced diagnostic and treatment options. Many patients with liver cancer are eligible for liver transplantation, but our surgeons will consider all options, including traditional open surgery and minimally invasive removal of the portion of the liver containing the tumors.

Living Donor Program

The Mass General Brigham Liver Transplant Program has an active living donor liver transplant program. Through living donor liver transplantation, a family member or friend donates a portion of their liver, allowing patients to receive a transplant sooner by shortening the waiting period compared to that of receiving an organ from a deceased donor. The donor’s healthy liver grows back to full size within a few weeks.

Donating a portion of your liver to another individual is a wonderful act of selfless generosity that can be lifesaving for the recipient. A live donor liver transplant requires complex surgery for both the donor and the recipient. In order to effectively plan for the surgery and ensure the best possible outcomes, our team evaluates living donors in a three-part process. Potential donors may choose to discontinue their evaluation at any point in the process, for any reason, with complete confidentiality. Typically, the recipient's insurance will cover the cost of the evaluation and surgery.

Phase One: Questionnaire and Blood Tests at Either Location
  • Donors must be between the ages of 18 and 55, and have no serious medical problems
  • The donor evaluation begins with the potential donor contacting our transplant center and answering a few questions that allow us to determine the donor’s overall health status
  • Standard blood tests will be done to determine blood type, liver function and overall health status. Blood testing can be performed at Mass General, Brigham and Women’s Hospital or at another local hospital
Phase Two: Team Evaluation and Surgeon Visit at Mass General
  • The donor will meet with our hepatologist, living donor nurse coordinator, financial coordinator, social worker, living donor advocate and nutritionist to learn about the donation process and to ask any questions
  • The evaluation includes a complete medial history and physical examination, and additional testing such as an electrocardiogram (EKG), chest X-ray, a CT scan of the abdomen to evaluate liver anatomy and other blood work or tests as needed
  • Next, the donor will meet with a surgeon from the Mass General Brigham Liver Transplant Program to discuss the surgical procedure and hospital stay. The operation is performed using a laparoscopic-assisted technique, and the majority of donors go home five to seven days after surgery
Phase Three: Anesthesia Evaluation and Scheduling Surgery at Mass General
  • Once all tests are complete, the transplant team will discuss the donor's eligibility at our weekly multidisciplinary liver transplant meeting to determine if the donor is approved for surgery. Once approved, we will schedule the surgery on a date that is convenient for both the donor and recipient
  • The donor and the recipient will meet with his/her surgeons at Mass General to sign the surgical consent forms and to ask any last-minute questions. The donor and recipient will also meet by phone with an anesthesiologist to discuss the anesthesia process and ask any additional questions

Become a living donor

Our Research

The Mass General Brigham Liver Transplant Program offers highly advanced treatments through innovative clinical trials. Current trials include those that seek to:

  • Develop the use of new organ preservation technologies that result in better post-transplant liver function and fewer complications
  • Improve transplantation of livers infected with hepatitis C
  • Eliminate the need for post-transplant immunosuppression
  • Provide transplantation of livers from HIV positive donors to HIV positive recipients

All of the following research trials are open and available for patients in the Mass General Brigham Liver Transplant Program.

Hepatitis C Positive Liver Transplant for Hepatitis C Negative Recipients

Currently there are more available hepatitis C positive deceased donors in New England than there are recipients. With the arrival of new anti-viral agents, Hepatitis C cure rates are almost at 100%. Under a clinical trial protocol, we will be transplanting livers from donors who are positive for hepatitis C virus into select recipients who are not infected with the hepatitis C virus. Patients who enter into this trial receive immediate pre-emptive treatment for hepatitis C. This will allow these selected recipients to be receive a transplant more quickly, avoiding many consequences of prolonged time on the waitlist.

Learn More

Liver Perfusion Device

Innovative studies are underway to improve the preservation and function of organs from deceased donors. Perfusion devices, or technology that temporarily replaces the functions of failing organs, may help solve the organ shortage by uncovering alternative sources for organs. The Mass General Brigham Liver Transplant Program is a leading site in the field of organ perfusion and preservation.

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HOPE Act: HIV+ Donors for HIV+ Recipients

Until 2015, transplanting organs from HIV positive donors was not allowed under the National Organ Transplant Act of 1984. However, since HIV treatments have improved and HIV positive transplant recipients have done well after transplant, the HIV Organ Policy Equity (HOPE) Act was recently passed. The HOPE Act allows organs from HIV positive donors to be transplanted into HIV positive recipients. These are organs that would have been discarded before the HOPE Act was passed. Mass General in the United States doing these transplants.

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Surgical Outcomes for the Liver

The Center for Outcomes & Patient Safety in Surgery (COMPASS) ensures that surgical data is transparent and accessible for patients. Watch the video to view Mass General's performance for procedures to treat conditions of the liver.

Our Doctors

The Mass General Brigham Liver Transplant team is a multidisciplinary team of doctors, nurses, case managers, financial coordinators and other clinicians who guide patients through every stage of care and help them navigate every element of the transplant journey as smoothly and with as much support as possible.

Meet our surgeons

Jim Markmann, MD, PhD

Jim Markmann, MD, PhD
Chief, Division of Transplantation, Mass General
Surgical Director, Mass General Brigham Liver Transplant
Surgical Director, Liver, Pancreas and Islet Transplant Programs
Clinical Director, Mass General Transplant Center

Meet Dr. Markmann

Leigh Anne Dageforde, MD, MPH

Leigh Anne Dageforde, MD, MPH
Transplant Surgeon, Mass General
Surgical Director, Mass General Brigham Liver Transplant, Brigham and Women’s Hospital
Assistant Professor, Harvard Medical School

Meet Dr. Dageforde

Nahel Elias, MD

Nahel Elias, MD
Surgical Director, Kidney Transplantation, Mass General
Chair of Quality Improvement, Mass General Transplant Center

Meet Dr. Elias

Tatsuo Kawai, MD, PhD

Tatsuo Kawai, MD, PhD
A.Benedict Cosimi Chair in Transplant Surgery
Surgical Director, Living Donor Transplantation and Dialysis Access Program
Professor of Surgery, Harvard Medical School

Meet Dr. Kawai

Shoko Kimura, MD

Shoko Kimura, MD
Transplant Surgeon

Meet Dr. Kimura

Heidi Yeh, MD

Heidi Yeh, MD
Surgical Director, Pediatric Transplant, Mass General

Meet Dr. Yeh

Meet our hepatologists

Raymond Chung, MD

Raymond Chung, MD
Gastroenterologist and Transplant Hepatologist 
Vice Chief, Gastrointestinal Division, Mass General
Director, Hepatology and Liver Center, Mass General
Medical Director, Mass General Brigham Liver Transplant Program

Meet Dr. Chung

Daniel Pratt, MD

Daniel Pratt, MD
Clinical Director, Mass General Brigham Liver Transplant, Mass General
Director, Autoimmune & Cholestatic Liver Center, Mass General

Meet Dr. Pratt

Anna Rutherford, MD, MPH

Anna Rutherford, MD, MPH
Clinical Director, Hepatology, Brigham and Women's Hospital
Clinical Director, Mass General Brigham Liver Transplant, Brigham and Women's Hospital
Assistant Professor of Medicine, Harvard Medical School

Meet Dr. Rutherford

Emily Bethea, MD

Emily Bethea, MD
Internist, Gastroenterologist and Transplant Hepatologist
Associate Clinical Director, Mass General Brigham Liver Transplantation

Meet Dr. Bethea

Mass General shield

Karin Andersson, MD
Gastroenterologist and Transplant Hepatologist

Meet Dr. Andersson

Irun Bhan, MD

Irun Bhan, MD
Gastroenterologist, Transplant Hepatologist and Internist

Meet Dr. Bhan

Kathleen Corey, MD, MPH

Kathleen Corey, MD, MPH
Gastroenterologist and Transplant Hepatologist
Director, Mass General Fatty Liver Clinic

Meet Dr. Corey

Nikroo Hashemi, MD, MPH

Nikroo Hashemi, MD, MPH
Hepatologist
Assistant Professor, Harvard Medical School

Meet Dr. Hashemi

Michael Thiim, MD

Michael Thiim, MD
Gastroenterologist
Ambulatory Clinic Director, Mass General Gastroenterology

Meet Dr. Thiim

Kathleen Viveiros, MD

Kathleen Viveiros, MD
Hepatologist
Instructor, Harvard Medical School

Meet Dr. Viveiros

Stephen Zucker, MD

Stephen Zucker, MD
Director of Hepatology, Brigham and Women's Hospital
Associate Professor, Harvard Medical School

Meet Dr. Zucker