Hepatology

What we do

Our hepatology (medicine of liver disease) service is renowned worldwide and is provided by a team of leading specialists in the field of liver disease.

Our Liver Unit treats a diverse range of liver conditions as well as rare diseases. These include:

  • alcohol related liver disease
  • non-alcoholic fatty liver disease
  • viral hepatitis
  • autoimmune hepatitis
  • primary biliary cholangitis
  • primary sclerosing cholangitis
  • autoimmune sclerosing cholangitis
  • advanced chronic liver disease (cirrhosis)
  • complication associated with portal hypertension
  • genetic liver disorders
  • metabolic disorders (for example, haemochromatosis, Wilson’s disease, alpha-1 antitrypsin deficiency)
  • transition medicine
  • hepatocellular carcinoma (liver cancer)
  • liver transplantation: pre-operative, peri-operative and post-operative care

Depending on your diagnosis, we aim for you to be seen by a specialist within six weeks of receiving the referral. At your appointment, the team will discuss with you the best way to treat your condition.

Liver Outpatients

We run outpatient clinics Monday to Friday (see location below). Most are consultant led, but we also run parallel nurse-led and pharmacy-led clinics. Experienced junior doctors may review you in clinic under a named consultant clinic. Our transplant co-ordinators also perform virtual consultations. We have outreach clinics that take place in the community and other hospitals.

We also run the following services:

  • phlebotomy services - Monday to Friday, 9am to 5pm
  • FibroScan© services - Monday to Friday, 9am to 5pm (except Tuesday pm)
  • ambulatory day care unit for elective ascitic drainage/paracentesis - Monday to Friday, 8am to 4pm
  • weekly “hot clinic”, designed to review patients quickly after hospital attendance

Services available to you

In addition to the specialist clinics listed above, we provide a wide range of other services to our patients with liver disease:

  • iron infusions in our day care unit
  • 24 hour on-call service for emergency endoscopy (haemorrhage from varices (bleeding from dilated tortuous vessels at the bottom of the gullet, stomach or small bowel))
  • portal hypertensive endoscopy lists to monitor and manage varices (dilated blood vessels secondary to liver disease)
  • complex endoscopic interventions (for example, endoscopic retrograde cholangio-pancreatogram (ERCP), spyglass or endoscopic ultrasound)
  • ultrasound-guided percutaneous (through the skin) and trans-jugular liver (through a vessel in the neck) liver biopsy
  • insertion of trans-jugular intra-hepatic porto-systemic shunt (TIPSS)
  • specialist treatments for hepatocellular cancers (HCCs)
  • involvement in clinical research and trials

We take a multi-disciplinary approach to all cases and work closely with the alcohol care team, gastroenterology, oncology, transplant surgical team, paediatric team, obstetric team, HIV team and our expert histopathologists and radiologists. Our services are well supported by our specialist nurses, dietitians, and pharmacists. As a tertiary liver transplant centre, we take referrals from and deliver care to the majority of the South of England.

Additional resources

Below are some useful links to websites that may be of interest to you. This does not mean we endorse or accept responsibility for the sites or the information provided on them.

Preparing for your appointment

If needed, we’ll send any extra instructions about preparing for your appointment or scan in the post. If you are a new patient, please bring any related clinical reports or letters you might have at home.

At your appointment

Depending on the case, you may meet a doctor, specialist nurse or pharmacist. If you are a new patient, your appointment will last between 20 to 30 minutes. Follow-up appointments last between 10 to 15 minutes.

You may have an abdominal ultrasound or FibroScan© appointment scheduled prior to your appointment with the doctor. Please attend these before coming to see us and check the instructions on your letter to see if you need to fast before attending these scans. You are also likely to have a blood test to assess your liver function after clinic. This is performed in the same department as your clinic appointment. No paper form is required as the blood tests are usually requested electronically.

The liver clinics can become very busy at times, so please allow for extra time after your appointment.

Queries

If you have any questions or concerns about your liver disease, please email or call the secretary or specialist nurse of the specific team which are looking after you. These details can usually be found in the top left hand corner of your last clinic letter.

For medical emergencies, please contact your GP or attend your local emergency department.

If you have any questions or concerns specifically about your liver medications, please contact our pharmacy team (see below).

If you have run out of medications, please direct your query to the clinical team looking after you so that they can provide you with an electronic prescription.

Location

Suite 9, Third Floor, Golden Jubilee Wing, King's College Hospital, Denmark Hill, London, SE5 9RS

Contact Details

Patient Information Leaflets

Conditions we treat

Our service has various clinics that investigate and treat the following conditions:

  • alcohol-related liver disease
  • fatty liver disease
  • viral hepatitis
  • autoimmune hepatitis
  • primary biliary cholangitis
  • primary sclerosing cholangitis
  • autoimmune sclerosing cholangitis
  • IgG4-related cholangiopathy
  • alpha-1 antitrypsin deficiency
  • haemochromatosis
  • Wilson’s Disease
  • portal vein thrombosis
  • Budd Chiari syndrome
  • veno-occlusive disease
  • hepatocellular carcinoma
  • benign liver tumours
  • cholangiocarcinoma
  • genetic liver disorders
  • acute and subacute liver failure
  • advanced chronic liver disease (cirrhosis)
  • portal hypertension (ascites, variceal haemorrhage and hepatic encephalopathy)

Our outpatient clinics reflect sub-specialisation in the field of liver disease. These include:

  • alcohol-related liver disease – led by Dr Naina Shah
  • fatty liver disease – led by Dr Ashley Barnabas
  • viral hepatitis – led by Dr Kosh Agarwal
  • hepatocellular carcinoma – led by Dr Abid Suddle, Dr Paul Ross and Professor Nigel Heaton
  • autoimmune liver diseases – led by Dr Michael Heneghan and Dr Deepak Joshi
  • metabolic liver disease – led by Dr Adrian Bomford and Professor Aftab Ala
  • encephalopathy and chronic liver disease – led by Dr Debbie Shawcross and Dr Brian Hogan
  • liver transplantation – led by Dr Varuna Aluvihare

What is required before referring a patient

For an effective consultation, it is important that all relevant blood tests are performed before a patient is referred to the Hepatology service.

Booking a patient at King's

GPs should refer via NHS e-referral (e-RS) wherever possible.

Other ways to refer

Routine Referrals

Other healthcare professionals can address routine referrals to "Referrals Co-ordinator" and liver assessment referrals to "Liver Transplant Referrals Co-ordinator" at:

Institute of Liver Studies
3rd floor, Cheyne Wing,
King's College Hospital
London SE5 9RS

Advanced Chronic Liver Disease MDM referrals
Tertiary referrers can refer patients with decompensated advanced chronic liver disease by filling in the form below and emailing it to: kch-tr.acldreferrals@nhs.net.

Emergency Referrals

To make an urgent referral, GPs should use NHS e-Referral and state that the referral is urgent.

The unit always has an on-call specialist registrar, supported by a consultant, to accept urgent referrals requiring inpatient assessment or advice. To contact them, call the main switchboard on 020 3299 9000 and ask for the liver SpR or on-call liver consultant.

Referral Forms

Please complete the relevant form and note any pre-consultation investigations required:

Key Clinical Staff

Name Job Title
Dr Huyen-Ly Adams Consultant in Hepatology and General Medicine
Dr Kosh Agarwal Consultant Hepatologist/ Transplantation
Prof Aftab Ala Consultant Hepatologist and Professor of Hepatology
Dr Varuna Aluvihare Consultant Hepatologist/Liver Transplant Physician
Mr Ashley Barnabas Consultant Hepatologist
Dr Adrian Bomford Reader in Medicine/Honorary Consultant Physican
Dr Sarah Brown Locum Consultant Hepatologist
Dr Mary Cannon Consultant Hepatologist
Dr Ivana Carey Senior Clinical Lecturer in Viral Hepatitis
Dr Michelle Cheung Consultant hepatology and general medicine
Mrs Pamela Conran Service Manager for Hepatology & Outpatients
Prof Geoff Dusheiko Professor
Mr Alejandro Esquivel Morocho Advanced Chronic Liver Disease CNS
Dr Matthew Foxton Consultant Hepatologist
Dr Phil Harrison Consultant
Dr Brian Hogan Consultant Intensivist & Hepatologist
Dr Sarah Hughes Consultant
Dr Deepak Joshi Consultant
Dr Eranda Luxman Senior Clinical Fellow
Dr Nicola Owen Consultant Hepatologist
Dr Vishal C Patel Consultant Hepatologist
Dr Tamir Rashid Consultant
Mr Daniel Robles Ortiz Advance Nurse Practitioner
Dr Naina Shah Consultant Hepatologist
Dr Jayshri Shah Consultant Hepatologist
Prof Debbie Shawcross Professor of Hepatology and Chronic Liver Failure
Prof Debbie Shawcross Clinical Lead for Education and Teaching
Dr Abid Suddle Consultant Hepatologist