Liver transplant

Liver Transplant is a highly successful treatment for patients with end stage liver disease.  

The Royal Free Hospital is one of seven U.K. centres receiving referrals and performing transplants for patients from a wide geographical area. The transplant program at the Royal Free began in 1988 and we have performed over 2000 liver transplants. The number of liver transplants undertaken at the Royal Free has been increasing annually over recent years. Patient outcomes are excellent when compared nationally, with 1-year survival more than 94% and 5-year survival 86%. 


Liver Transplant Assessment 

Patients require liver transplants for a variety of reasons including acute liver failure, cirrhosis and its complications and liver cancer. 

The Royal Free runs a dedicated outpatient liver transplant assessment clinic where we are able to perform a comprehensive assessment of a patient’s candidacy for Liver Transplant. Alternatively the Royal Free provides out-reach services to several centres (Bournemouth, Bristol, Cardiff, Frimley, Oxford, Portsmouth) where a transplant physician reviews patients in their local hospital alongside their local team.  It is our target to review all outpatient referrals for liver transplant within 2-4 weeks, depending on urgency, and more urgent cases or cases of acute liver failure will be transferred to the hepatology ward or the liver intensive care unit for urgent inpatient evaluation.  

After initial assessment patients underdo a formal assessment for transplantation which takes part at the Royal Free Hospital. The majority are done over 2 days with patients (and a chosen next of kin) staying in local accommodation provided by the hospital. During this assessment patients undergoes a variety of investigations  and are reviewed depending on their needs by members of the transplant team (consultant hepatologist, consultant surgeon, consultant anaesthetist, transplant dietician, transplant physiotherapist, specialist nurse in substance misuse and clinical psychologist).  

The purpose of the assessment is to understand in detail your general health, liver health and psychological and social wellbeing to understand if a liver transplant is the best form of treatment for you. During the assessment process extensive education regarding liver transplant (including risks, benefits, what will happen during the transplant and life after transplant) will be given to you and your family. 


The Liver Transplant Waiting list 

The average wait for a liver transplant in the U.K. varies depending on your blood group, indication for liver transplant and severity of liver disease. Patients on the liver transplant waiting list are reviewed regularly either at the Royal Free Hospital or at a dedicated outreach centre. This is to ensure patients remain suitable for a liver transplant with respect to their fitness, nutrition and indication for the transplant.  


Post-Transplant Management 

Following the liver transplant patients will initially managed on the “Liver Intensive Care Unit” located on the 4th floor and when clinically stable be transferred to 9 North, the hepatology ward.  

The length of stay following a liver transplant operation is highly variable depending on multiple factors, however the average length of stay at the Royal Free Hospital is 2 weeks.  

Following discharge patients are seen initially weekly in the post-liver transplant clinic with the interval between appointments increasing as a patient’s clinical condition stabilises. Liver transplant patients are kept under life-long follow-up by their transplant centre.  

The goal following transplantation is cure of liver disease and its complications with an expectation of a return to a full and active lifestyle with a good quality of life.