The liver is the largest solid organ in the body. It detoxifies, protects and provides nutrients for all cells in the body, and performs around 500 functions to keep the body healthy. When the liver is diseased and unable to function patients can become extremely unwell, leading to gradual failure of other organs. Liver transplantation is the replacement of a diseased liver with either all or part of a healthy liver from a donor.
The ĢtvƵ Liver Unit offers services in all aspects of liver transplantation from assessment through to long-term post-transplant care. It is one of 6 centres in England commissioned by NHS-England. The first liver transplant in ĢtvƵ was carried out by Professor Geoffrey Giles in 1986. The program has grown since then and is now the 3rd largest in the UK. Our centre serves patients from across the North of England, and works closely with our referring hospital teams.
In 2007 we became the first liver transplant program to provide live donor transplantation for NHS patients.
The transplant team is multi-disciplinary, and includes hepatologists, transplant surgeons and anaesthetists as well as other professionals such as our ward nursing team, liver transplant co-ordinators, dieticians, pharmacists, specialist nurses in alcohol and substance misuse, physiotherapists, social worker and many others, including our administrative teams. As a teaching hospital and specialised unit we have an important role in teaching medical students, and training doctors at all stages in specialist aspects of liver transplant medicine and surgery. The team holds a large multidisciplinary meeting each week.
The unit works collaboratively with several organisations including NHS Blood and Transplant, our regulatory body, and complies with nationally agreed standards for assessment and registration of patients on the liver transplant waiting list.
Please read our information on the Liver Transplant Support Group who provide support for patients and their relatives or carers.
Outpatient Transplant Services
The Liver Unit offers several outpatient services within the liver transplant programme.
We work closely with a wide network of hospitals across the North of England and patients who access this service are cared for jointly by their local hospital specialists and those here in the Liver Unit.
Our clinics are held in the Bexley Wing and Lincoln Wing of St James’s University Hospital.
Transplant Assessment
Patients are referred by their local hospital specialists for an opinion regarding liver transplantation.
Patients referred for possible transplant assessment are seen in our outpatient clinic in the first instance. Specialist delivered assessment is offered through our subspeciality clinics and through a new patient assessment clinic. All our transplant assessment services are consultant led.
From these clinics patients may then be referred for a formal transplant assessment which in the majority of cases can be offered in an outpatient setting.
Pre-Transplant Clinic
This clinic provides ongoing assessment for transplant and care for patients on the liver transplant waiting list. It is part of a transplant super-clinic supported by the multidisciplinary team so that care can be tailored to individual patient needs.
Post-Transplant Clinics
Following discharge from the ward after a liver transplant patients attend our post-transplant services. Follow-up is lifelong although longer-term more stable patients enter shared care arrangements with their local hospital services and general practitioners.
Liver Transplant Assessment
If your doctor thinks that there is a good reason to consider liver transplantation, they will refer you to our team for assessment.
The transplant assessment process focusses mostly on the condition of your liver, but it also looks at your general health including heart and lung function, to help us decide if you are strong enough to undergo liver transplant.
If you are well enough and able to walk between departments, this assessment can be done as an outpatient. It is often possible to complete all of the necessary tests within a single day, but if assessment over more than one day is necessary we can arrange accommodation in the hotel in Bexley Wing if this is required. If you are not well enough for outpatient assessment then you will be admitted to the ward for the necessary tests to be done.
During the assessment you will have a number of investigations that may include an MRI scan, echocardiogram (“echo”), electrocardiogram (ECG), lung function tests and a chest X-ray.
You may be seen by a number of different members of the transplant team during assessment:
- Liver Transplant Coordinators will explain the assessment process to you and will be able to answer any questions you may have
- A Hepatologist may be the first member of the team that you meet in the assessment clinic, and will oversee the assessment process
- A Transplant Surgeon will see you to explain the surgical risks of transplant
- A Transplant Anaesthetist will explain the overall risks of transplant, and may request further tests to decide whether you are strong enough to undergo the operation
- You may also meet other members of the team including a dietician, social worker, substance misuse specialist nurse and pharmacist
The assessment is completed as quickly as possible, although if you require more specialised tests or opinions it may take several weeks. Your case is discussed in detail with the whole transplant team in our multidisciplinary meeting.
Post-Transplant Care
Liver transplantation involves a long-term commitment to medical follow-up as transplantation medication requires careful monitoring and there are health issues that can arise as a consequence of immunosuppression (anti-rejection) therapy.
Initial post-transplant care requires frequent monitoring for complications and adjustment of medication and the majority of that takes place in ĢtvƵ. Gradually, as patients stabilise after their transplant, the follow-up becomes more tailored to the individual patient’s needs and the frequency of visits to ĢtvƵ reduces.
Our administrative staff work closely with the clinical team to ensure that communication links with patients, their GPs and their local hospital specialists are maintained.
Our services have adapted to patient requests for easy access to our staff for non-urgent advice and our liver specialist nursing team offers a telephone advice service for patients.
Post-Transplant Specialist Nurse
Elisabeth Yates and Chris Sutton specialise in the care and support of patients who have had liver transplants.
Usually, patients will meet in clinic and for an education session around three months after their transplant.
Lis and Chris can be contacted via the advice line: 0113 2068184
Please leave a message if there is no answer and we will get back to you ASAP Monday to Friday 8:00am to 6:00pm.
Please note that this is not an emergency service. If you need urgent medical attention or advice please contact your General Practitioner.
Contact Us
If you wish to contact us please call and leave a message and one of our transplant coordinators will ring you back.
