Guide for Aviation Medical Examiners

Decision Considerations
Disease Protocols - Liver Transplant (Recipient)

The Examiner must defer initial issuance. An applicant with a history of liver transplant must submit the following for consideration of a medical certificate.

Requirements for initial consideration:

  1. A six (6) month post-transplant recovery period with documented stability for the last three (3) months;
  2. Pre-transplant treatment notes that identify the diagnosis, indication for transplant, and any sequelae prior to transplant. If alcohol was a contributing factor (abuse or dependence), submit evidence of treatment and recovery;
  3. Hospital reports to include admission note, operative note, and hospital discharge summary;
  4. A current status report from the treating physician that describes:
    1. The status of the transplant, functional capacity, modifiable risk factors, and prognosis for incapacitation; and
    2. Any recent or expected change in treatment plan
  5. Complication history such as:
    1. Rejection or graft versus host disease/GVHD;
    2. Infection Hepatitis C (HCV) or CMV; and/or
    3. Malignancy due to hepatocellular carcinoma (HCC) or following transplant and initiation of immune-suppressants
  6. Current medication list to include names and dosage of immunosuppressive medications, the presence or absence of any side effects, and how long the airman has been on these medications.
  7. Lab and images to include copies of most recent lab performed by the treating physician (CBC, CMP with LFTs) and any other tests deemed necessary by the treating physician such as imaging or liver biopsy.

Recertification: Applicants found qualified will be required to provide follow up evaluations. This includes updated items 4-7 above, plus any additional information specifically requested in the airman's Authorization letter.

Last updated: Thursday, September 3, 2020