Liver

Liver and Hepato-BiliaryServices

Liver Team

The Hepatology/Liver team at the Royal Liverpool University Hospital includes 5 Consultants, one Nurse Consultant, three middle grades doctors (Specialist Registrars), two Nurse Specialists, and a Hepatology Nurse (see tabe 1 below).  There are also a team of Radiologists with a special interest in Hepatology as well as a Superintendent Radiographer with a specialist interest in ultrasound guided liver biopsy.

Table 1: The Liver Team

 

Clinician/Specialist

 

 

Job Title

 

Contact Details

Dr Paul Richardson

Consultant Hepatologist

Clinical Lead - Hepatology

0151 706 3568

Dr Howard Smart

Consultant Gastroenterologist with interest in Hepato-Biliary Medicine

0151 706 3557

Prof Martin Lombard

Consultant Hepatologist

 

0151 706 3558

Dr Sanchoy Sarkar

Consultant Gastroenterologist with interest in Hepato-Biliary Medicine

0151 706 3554

Professor Sir Ian Gilmore

Consultant Hepatologist

0151 706 3558

Helen Caldwell

Nurse Consultant

0151 706 2805

Julie Barr

Nurse Specialist

0151 706 2453

Devina Mallon

Nurse Specialist

0151 706 2725

Steph Gray

Administrator

0151 706 2820

Out-Patient and In-patient Services

The outpatient services are shown in table 2 below. They consists of a joint ‘liver clinic’ involving 4 Medical Consultants, the Nurse Consultant, Specialist Nurse and three SpRs.  There is a strong emphasis on standardized protocols and education. We accept referrals from primary, secondary and tertiary care.  There are also three nurse led services, which include clinics for the treatment of viral hepatitis, haemachromatosis and long term chronic liver diseases.  There are also pre-assessment clinics for patients undergoing procedures such as ERCP and ultrasound guided liver biopsy.  A ‘virtual clinic’  is also undertaken by the Nurse Consultant and Specialist Nurse which involves pre-investigating all our new out-patient referrals to the liver team, allowing us to give a diagnosis, offer treatment or even discharge on the first appointment.

The Billary SytemThe Liver Service organises and performs all of the ERCP (~450pa) and EUS (~550 pa) within the Trust and works very closely with the surgical HPB unit and radiology.  Approximately 100 patients are treated for hepatitis C per year and approximately 250 ultrasound guided liver biopsies are performed as day cases by either the Nurse Consultant in Hepatology or the Superintendent Radiographer.  There are also approximately 140 patients with genetic haemachromatosis and approximately 15% require weekly venesections with the remaining 85% having three monthly venesections. 

Care is also provided in a ward environment.  This is a 24 bedded ward primarily caring for patient with hepatobiliary conditions, servicing the local community as well as offering a tertiary service for Merseyside, IOM, Lancashire, Cheshire & North Wales.

Table 2:Out Patient-Services

Clinic

 

Description

Lead

Contact Details

Liver Clinic

This is the main ‘Liver Clinic’ with 3 Medical Consultants, a Nurse Consultant, 3 SpRs and Specialist Nurse.  All patients are pre-investigated before they attend the clinic and there is also an emphasis on standardized protocols and education.

 

Martin Lombard – Consultant Gastroenterologist

 

0151 706 3568

Viral Hepatitis Treatment clinic

Nurse led clinic offering treatment for patients with hepatitis C or B.  This is a joint clinic with the specialist nurses in Infectious Diseases.

 

Helen Caldwell – Nurse Consultant

0151 706 2805

Chronic Disease Management clinic

Nurse led clinic for patients with chronic liver diseases such as PBC, autoimmune hepatitis who require management of their disease and monitoring of their immunosuppressant medication. 

 

Helen Caldwell – Nurse Consultant

0151 706 2805

Transplant Clinic

Nurse led clinic for patients who have undergone a liver transplant.  The clinic offers support for the patients as well as regular monitoring for side effects related to their immunosuppression medication.

 

Helen Caldwell – Nurse Consultant

0151 706 2805

Haemachromatosis Clinic

Nurse led service on the Gastroenterology Unit, offering counselling and screening of patients and their families with genetic haemachromatosis, as well as running a regular venesection programme.

 

Devina Mallon – Specialist Nurse

0151 706 2725

Pre-assessment clinic

This is a service that works along side the gastroenterology unit and the specialist nurses.  Patients are assessed, consented and sent for necessary investigations prior to day case procedures such as ultrasound guided liver biopsy and ERCP.

 

Susan Williams – Hepatology Nurse

0151 706 2725

Pre-investigation Service

All out-patient referrals go through a system of pre-investigation prior to their clinic consultation.  This involves arranging appropriate investigations as well as correlation of results.

 

Julie Barr – Hepatology Specialist Nurse

0151 706 2453

Ultrasound guided liver biopsy

Ultrasound guided liver biopsy performed in Interventional Theatres.  These procedures are performed as day cases.

 

 

Helen Caldwell – Nurse Consultant

0151 706 2805

Adolescent Liver transitional Clinic

This clinic is run with the paediatric department for adolescent patients who will soon be transferring to the adult liver service.

 

 

 

Helen Caldwell – Nurse Consultant

0151 706 2805

Joint Viral Hepatitis / Haematology Clinic

Joint clinic with the Haematology department in the management & treatment of patients with hepatitis C and haemophilia.

 

Helen Caldwell – Nurse Consultant

0151 706 2805

Viral Hepatitis C clinic – Primary Care

Joint viral hepatitis treatment clinic with the local GP practice and the community hepatitis nurse.

 

Helen Caldwell – Nurse Consultant

 

Jayne Wilkie – Hepatitis C nurse in Primary Care

 

0151 706 2805


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