The Royal Free London NHS Foundation Trust is one of the most prestigious medical institutions in the United Kingdom and is a leading centre for the diagnosis and treatment of all conditions affecting the liver, pancreas and biliary tree.

Dame Professor Sheila Sherlock, the ‘mother of hepatology’, founded the liver unit in the early ‘50s and was one of the greatest contributors to the development of this discipline. The liver centre is named after her. The Royal Free Hospital hosts one of the two liver transplant and hepato-pancreato-biliary (HPB) units in London and is a designated cancer centre for the treatment of tumours of the liver and pancreas. The institute has the largest neuroendocrine tumour service in the UK, which is nationally funded, and as a result a large number of neuroendocrine pancreatic primary and liver secondaries are treated in our institution.

The recent designation as an Academic Health Science Centre (UCL Partners), in partnership with University College Hospital, Great Ormond Street and other key hospitals, provides a huge range of investigatory and therapeutic options. No other collaborative group in the UK can offer a similar service. The gastroenterology and hepatology partnership clinical and academic services rank in the world top ten, with a superb international reputation for its research, service and education.

At the Royal Free Hospital, a large number of specialists work in the HPB and liver transplant unit. A multidisciplinary approach is crucial in the management of our patients and about 50 consultants cover different areas of expertise. Surgeons, hepatologists, gastroenterologists, radiologists, oncologists, radiotherapists, nuclear medicine physicians, histopathologists, virologists and microbiologists have regular scheduled meetings to discuss the best treatment plan. Extensively trained nursing staff, clinical nurse specialists, transplant co-ordinators, perfusionists, dieticians and physiotherapists all contribute to the multidisciplinary approach. Finally, we benefit from technical equipment and expertise which only a liver transplant centre can offer, including the outstanding skills of the anaesthetic and intensive care personnel. All of this ultimately translates into excellent clinical results and improved patient safety.

The liver transplant programme began in 1988 and since then, more than 1,100 liver transplants have been performed. Progress in the transplant field has led to the development of a range of techniques, which are all available here at the Royal Free London NHS Foundation Trust. Split grafts (two grafts from one liver), organs from non-heart beating donors and living-related liver transplantation are currently performed at our institution.

Patients with hepatocellular carcinoma, advanced chronic liver disease and liver cirrhosis are admitted for an extensive but rapid assessment to establish their suitability for transplantation. Patients with acute liver failure are urgently transferred to our intensive care unit, where joint care between intensivists, hepatologists and surgeons, is essential in the management of multiple organ failure and to select those cases which would benefit from liver transplantation.

Five transplant co-ordinators work in the transplant team. Part of their role is to provide patients and families with customised information and psychological support, throughout the transplant process. After the transplant, they give advice about the necessary medications and how the patient can return to a normal lifestyle.