Liver Transplant Evaluation and Assessment Guide

Until liver transplantation commenced in the 1980’s as a treatment for advanced liver disease, patients had a limited chance and faced certain death. Development of liver transplant programs offered new hope and enabled many adults and children with liver disease to experience the amazing benefits of transplantation, including a significant improvement in health, quality of life, and of the lifespan itself. Liver transplantation has been praised by many as a miracle.

A number of people with liver disease will either not have the opportunity for a transplant or will experience an unsuccessful transplant outcome. One of the issues is the shortage of donor organs available for transplant, compared with the number of people needing a liver transplant. When a donor liver does not become available in time for a patient, or when a re-transplant is not possible, or if a post-transplant patient develops another life threatening medical situation; the patient

will progress to the point where they might need palliative care. Palliative doctors and nurses provide supportive professional care when other treatments might not be so useful or possible. The palliative care team also supports the needs of patient’s carers and loved ones. The focus of palliative care is upon providing compassionate physical, emotional and spiritual care and comfort to the patient and their family.

How would I know that I need palliative care?

If transplantation is not a viable option or if a previous transplant is failing and re-transplantation is not possible, your doctor will discuss the different treatment options with you and your family. One possible outcome might be a referral to palliative care service.

How would I start palliative care?

If it is agreed that palliative care is a suitable treatment pathway for you, then you will be referred to the palliative care team. If you are an inpatient of the Princess Alexandra Hospital (PAH), the Metro South palliative care staff will explore the options with you and your family. If ongoing inpatient care is needed, you might be transferred to your local hospital and the palliative team for ongoing support. Or, you might stay as an inpatient of the PAH and your care would be managed by both the PAH hepatology and palliative care teams.

If you are an outpatient at the time, then you would be referred to your local palliative care service for ongoing support at home. There are palliative care services throughout Australia, including your general practitioner, specialist palliative care doctors, nurses, social workers, counsellors, psychologists and other health care specialists.

Where do I receive palliative care?

Palliative care can often be provided at home. Many people prefer to be cared for in familiar surroundings and where possible, this wish for home-based care is supported. Sometimes it becomes necessary to receive care in a local hospital or in a palliative care unit within a hospital setting, if your medical or nursing needs are too much to be provided at home. Home might not be the most suitable place for some patients and their families. Care can often be shared between an inpatient facility and the home, in order to provide respite for the family and optimal management of the patient. Flexibility and choice are the keys to good palliative care. Generally, palliative care is at no or low cost to the patient and family.

Can palliative care teams assist with pain management?

Pain management and easing of symptoms is a major role of palliative care. There are many ways in which pain and other symptoms, for example nausea, breathing problems can be helped. Your doctors will be able to explain your medication needs in more detail to help with your needs. Most palliative care services provide 24-hour phone support.

How else can palliative care help?

Counselling and pastoral care is available, and volunteers can provide a break for carers. Through the palliative care services, families and carers can connect with others in the same situation, many finding this network of support comforting.

More information

• Metro South Palliative Care
• Palliative Care Australia
• Palliative Care Queensland
  • Phone: (07) 3842 3242
  • Email: hello@palliativecareqld.org.au
• St Vincent’s Private Hospital Brisbane Palliative Care
• Karuna Hospice Service
  • Phone: (07) 3632 8300
• Canossa Hospital
  • Phone: (07) 3717 5555
• Australian Centre for Grief and Bereavement
• Queensland Cancer Council Helpline
  • Phone: 13 11 20
• Advance Care Planning
• Head to Health
• Carers Australia