Liver transplants

A liver with decompensated cirrhosis cannot be propped up indefinitely. Unlike the kidneys or the heart, the liver cannot be kept going artificially. Eventually it will fail completely. Unless a transplant is performed the patient will die.

Despite the complexity and risks involved in the operation, liver transplants have a good success rate. Over 80% of liver transplants are considered successful. Success is defined as the patient being able to enjoy a normal or near normal life within a year of the transplant.

With major advances in surgical techniques survival rates have improved considerably. These rates have also been helped by improvements in post-transplant medical management and the availability of better immunosuppressive drugs to counter the body’s attempts to reject a new liver.

Survival rates for liver transplants for people with hepatitis B and C between 2013- 2017 were 97% at one year and 78% at five years.

The number of people receiving liver transplants has increased substantially over the last decade. Between 1 April 2017 and 31 March 2018, a total of 1043 patients received a liver transplant, up from 702 eight years ago. The number of people waiting for a liver transplant has gone down in recent years, from 611 on 31 March 2015 to 359 on 31 March 2018, partly due to less demand for hepatitis C-related liver transplants following the introduction of DAA treatments. Transplants are only carried out at specialist units. There are seven transplant units in the UK, with six across England and one in Scotland.

Of all liver transplants performed in England in 2017, the percentage carried out in patients with HCV-related disease was 8%, less than half what it had been 10 years previously. 

In England, the number of people undertaking liver transplants because of post-HCV cirrhosis has fallen by 53% compared to previous years, reaching a ten-year low of 63 transplants in 2017. This is likely because of the effectiveness of DAA treatment, available from 2015.

The average waiting time for low-risk patients in the UK is approximately 135 days.

The limited supply of donor livers and the increase in the number of people waiting for transplantation led to the creation of a national organ scheme to ensure equality of access to treatment across the country. Organs are now seen as a national resource. Whilst research and the development of new transplant techniques have increased the uses of donated organs, the shortfall in donors means that some people die waiting for a liver to be become available. There is also the possibility that their health will deteriorate to the extent that they will be unable to undergo the operation.

Currently in England and Scotland people have to ‘opt in’ for organ donation. However, in 2020 England and Scotland will be joining Wales in introducing an ‘opt out’ system for organ donation, meaning people will automatically be signed up to donate their organs when they die unless they state otherwise. At the moment there are around 24 million people (around 36% of the population) registered on the NHS Organ Donor Register.

To find out more about signing up to the organ donor register click here.

Information

Assessment for transplant

What to take into consideration when put on the liver transplant list

The operation

How transplants work, and what to take into consideration when getting one.

Recovering from a transplant

After the transplant you need to recover and go through a period of adjustment.

Hepatitis C after a transplant

Tackling the recurrence of hepatitis C after a liver transplant.

Liver transplant statistics

The number of liver transplants conducted in the UK.