Liver transplantation

What we do

King’s Liver Transplant Unit runs the largest transplantation programme in Europe, carrying out more than 200 procedures a year. We assess and treat both adults and children from all over the country and abroad.

We provide an integrated, multidisciplinary service which includes:

• Assessing patients’ suitability for transplantation This can be undertaken as an inpatient or an outpatient and includes imaging, blood and lung function tests, cardiac assessment and clinical review. It is supervised by a dedicated transplant hepatologist. Eligibility for the waiting list is decided after a multidisciplinary meeting of surgeons, hepatologists, anaesthetists, intensive care physicians, specialist transplant nurses (transplant coordinators) and social workers.
• Comprehensive education and support for all patients on the waiting list Patients meet all members of our team and are closely linked to a transplant coordinator while we are caring for them. They attend a specialist consent clinic where a consultant surgeon explains the transplant process and obtains the patient’s consent for the operation.
• Transplant surgery with aftercare When a suitable organ becomes available it is allocated to the most appropriate patient on the waiting list. We ask them to come to King’s as soon as possible to be assessed before they go to theatre. After surgery all patients stay on the Liver Intensive Therapy Unit (LITU) for 24-48 hours and then go to Todd Ward for further care.
• Post-transplant care and follow-up Newly transplanted patients are seen in clinic at least once a week; the interval between clinic appointments is gradually extended and established patients are seen every four - six months. The team offers help and advice outside of these appointments. All patients take anti-rejection (immunosuppressant) drugs long term and are monitored regularly to minimise any side-effects.
  

We offer a number of standard and more innovative techniques, such as:

• split liver transplantation, where the left part of the liver is transplanted into a child and the right to an adult
• living donor liver transplantation, where a segment of adult liver is transplanted into a child or another adult
• auxiliary liver transplantation, where a liver graft is transplanted alongside part of the patient's own organ.
  

King's is one of three centres nationally that carries out both the isolation and transplantation of islet cells. The latter is used to treat people with difficult to control Type 2 diabetes.

Preparing for your appointment

You will need a series of investigations before your assessment for transplantation at King's which will be organised by your referring doctor.

Location

Third floor, Cheyne Wing, Denmark Hill, London, SE5 9RS

Contact Details

Patient Information Leaflets

Conditions we treat

Patients can be referred for transplant assessment via the Hepatology and Gastroeneterology services at referring hospitals. The assessment for suitability for transplantation involves an in- or outpatient evaluation including imaging, blood tests, lung function tests, cardiac assessment and clinical review. Once a week, patients deemed appropriate for listing are added to the waiting list after a multi-disciplinary meeting of surgeons, hepatologists, anaesthetists, intensive care physicians, transplant coordinators and social workers.

All patients added to the list receive a comprehensive education session on what it is like to have a liver transplant plus an information pack. They will meet all members of the team and be closely linked to a transplant coordinator for the duration of their care with us.

Once on the waiting list all patients attend a specialist consent clinic where a consultant surgeon explains the different transplantation processes and techniques and acquires consent for the procedure.

What is required before referring a patient

The following clinical information and investigations are optimal at referral:

• Clinical summary including hepatological diganosis (including episodes of variceal haemorrhage; encephalopathy; diuretic resistant ascites), reason for referral and significant comorbidities/associated illnesses.
  

• Investigations including full biochemical profile, liver profile (including hepatitis screen; Ferritin: alpha-1-antitrypsin; copper+caeruloplasmin; autoantibody screen (including smooth muscle and anti-mitochondrial); immunoglobulins; alpha-fetoprotein.
  

• Imaging; adominal utrasound/CT scan/MRI as appropriate (by CD with referral).
  

• Echocardiogram
  

• Lung function.
  

Booking a patient at King's

Routine Referrals

Routine referrals should be sent to:
Referrals Co-ordinator
Institute of Liver Studies
3rd Floor, Cheyne Wing
King's College Hospital
Denmark Hill
London SE5 9RS.

Alternatively, fax referrals to 020 3299 3167.

They can also be sent via a named consultant in the unit (see Key Clinical Staff tab).

Emergency Referrals

There is always a duty hepatology SpR, supported by a consultant, on call for the unit to accept urgent referrals requiring inpatient assessment or advice. Call via the main switchboard on 0203 299 9000 and ask for the hepatology SpR on call.

Other Queries

For advice and guidance for urgent referrals, please contact the duty Hepatology via the main switchboard on 0203 299 9000 and ask for the hepatology SpR on call.

For routine referrals, please contact the Referrals Coordinator on 020 8299 5812.

Referral Forms

There are no referral forms for this service.

Key Clinical Staff