Transplant Unit

You will be admitted to hospital for between one and two weeks. During this period, your Doctors will be able to fully assess how your liver is functioning, and if there is any treatment that could improve it. A series of tests will be performed in order for your Doctors to decide whether transplantation would be the best form of treatment for you. In some cases a Liver Transplant is not the best option - if this is the case, you will be given a full explanation of the options available to you.

Whilst you are in hospital, you will meet many members of staff. Please take this opportunity to ask the Transplant Co-ordinator / Nurses / and Doctors as many questions as you wish. If you are to undergo a Liver Transplant Operation, it is a very big commitment that needs careful preparation.

Which members of staff will be involved with my care?

The Transplant team all contribute to your care. The key people you will meet are:

Professor Andrew Bradley - Consultant Surgeon

Mr Neville Jamieson- Consultant Surgeon

Mr Chris Watson- Consultant Surgeon

Mr Paul Gibbs – Consultant Surgeon

One of these Surgeons will perform your transplant operation, together with at least two other surgeons and theatre nurse.

Dr Alex Gimson - Consultant Hepatologist

Dr Graeme Alexander- Consultant Hepatologist

The Hepatologists will be responsible for your medical management both before and after your transplant

In addition to meeting the medical staff, you will also meet the transplant co-ordinator the dietician, physiotherapist and of course the nurses. You will be allocated a named nurse on admission. This nurse, although not with you for 24 hours a day is responsible for your nursing care.

You may require some or all of the following

Anaesthetic assessment

You will be seen by a consultant anaesthetist, who will assess your suitability for an anaesthetic

Ascitic tap

A small amount of fluid is taken from your abdomen with a needle (to check for infection)

The blood tests

Blood group

How well your blood clots

Liver function

Kidney function

The presence of viruses such as hepatitis, cytomegalovirus,and H.I.V.

Chest x ray

To detect any abnormality in the heart size and lungs

C.T. Scan

A computerised x-ray which gives more detailed information, and helps the Doctors see whether you have any abnormality that may effect a surgical procedure

Dental assessment

To exclude abscesses/decay or other sources of infection

Electrocardiograph (ECG)

A test to detect any abnormality of your heart

Echocardiogram

Sound waves are used to assess your heart function

Liver biopsy

A biopsy is performed to accurately assess the extent of liver damage, and its cause,

A needle is inserted through the skin on your abdomen into your liver. A small piece of tissue is then removed with the needle. Local anaesthetic is used for this procedure and you will need to remain in bed for a minimum of 12 hour afterwards.

Liver ultrasound

Sound waves are used to create a picture of your liver and surrounding organs.

Nutritional assessment

Your dietician will assess your nutritional state, and advise you on your diet

Urine samples

Your urine will be checked regularly for signs of infection. You may also be asked to collect your urine over a 24 hr period so that your kidney function can be assessed.

After all your tests and investigations have been performed, and you have had the opportunity to meet the staff on the unit and ask all the questions that you wish, your case will be discussed by the medical staff. A decision will be made as to whether a liver transplant is the most appropriate treatment for you. In some instances, it may be too early to consider a transplant, in which case you will be regularly reviewed in the hepatology clinic. Sometimes the tests show other problems which mean that it would not be beneficial for you to have a transplant. You and your family will have ample opportunity to discuss the results of the tests with the medical staff - please do not be afraid to ask!

If a liver transplant is not felt to be the most appropriate form of treatment, you will be followed up in an out-patient clinic – either at Addenbrookes Hospital or at your referring hospital..

If a liver transplant is felt to be the most appropriate form of treatment for you, you will be placed on the waiting list.