Adult liver transplantation for the Advanced Clinical Practitioner: an overview

Abstract

Liver transplantation (LT) is a major surgical undertaking, but, in a carefully selected population provides excellent outcomes in terms of prolongation of life and improvements in quality of life. This article outlines the processes of referral, assessment, operative course and post transplant complications of liver transplantation, in the UK context. Specific consideration is also given to immunosuppressive medications and considerations around their prescription. The role of the Advanced Clinical Practitioner (ACP) in primary or secondary care may focus upon identifying potential candidates for transplantation and ensuring timely discussion and referral. Thus, a familiarity with eligibility criteria, and where to access this information, is important for all ACPs. Additionally, the increasing numbers of transplants performed in the UK mean that there is a large population of posttransplant patients in the wider community. These patients may present to healthcare services with a variety of issues relating to their LT, where early recognition and treatment has the potential to have major impacts on patient, or graft, function and longevity. Due to this, a low threshold for ACPs to discuss with specialist transplant centres is generally advised.