Hi WD! UNOS has some very involved, complicated policies and guidelines that can be very difficult to read through and understand, especially if someone is outside of the 'business', life most of us! For instance, the issue with a tumor having to be at least 2cm before the patient can be listed. This is considered to be a stage 'T2' lesion - the tumor must be at least 2cm to be classified as a T2, per UNOS. However, UNOS has policies for other stages of tumors, such as after CE or other treatment has reduced the size of the tumors. To put it as simply as possible - when being evaluated for a transplant when HCC is involved, each person is considered individually, of course - and they look at all of the approved criteria, i.e. size of tumor, current/past treatment, general life expectancy (in regards to the HCC), etc.). In your mothers case, in order to be staged at a T2 (because of a combination of all relevant criteria) and be eligible for a transplant, her tumor had to reach 2cm.
I hope this makes sense! Liver transplant evaluation is not a 'one size fits all' process - there are several different groups of criteria that must be met in order to be eligible: Group A - 1, 2, and 3 must be met; Group B - 1, 2, and 3 must be met.....and so on. So one patient might become eligible because they met all of Group A's criteria, others because they met the criteria of Group B, etc. Some criteria are universal. You can't be over a certain age, for example - no matter what 'criteria group' the patient's eligibility is based on, he/she can't be over a certain age (I think it's 65, but I could definitely be wrong on that.).
UNOS dictates how certain things are to be done, and others are left to the individual transplant centers - and for those things, UNOS gives guidelines. The various regions are very different - size, population, historical data on total of donors/recipients, etc. So some guidelines/criteria have to be slightly different in order to accommodate those differences.
It's so hard to explain things like this in a post - sometimes what's in my head doesn't come out the same on 'paper'! C: Hope it helps a little.
It is important to do research (I did a ton, and still do), however, you have to balance that with 'what is', if you know what I mean. You HAVE to take care of yourself, because when that call does come, THAT is when your mom is going to need you the most. And if you've gotten yourself completely stressed out and sick (like I did), you are not going to be able to do what needs to be done. In my case, I couldn't be at the hospital after day 3 post-transplant and I was still sick when my fiance got home. I was sick, rundown, exhausted. I'm the type of person that can get through anything. I've prided myself on the fact that I can 'do it all'! Boy is THAT attitude a mistake when you're going through something like this! My mind and heart said I could handle it - but my body said 'NO WAY'! I am still not 100%, 5 months later - that is how rundown I got and I mostly did it to myself. So PLEASE remember to take care of yourself and slow down; remind yourself that what 'will be, will be', that everyone is doing what they are supposed to be doing (i.e. the transplant people) - even when it feels like they're not, that the call will come, that it will all work out in the end.
Have a peaceful day.
Post Edited (Splashdancer) : 4/1/2013 12:37:24 PM (GMT-6)