Providing liver transplant care at a distance: the role of networks

Liver transplantation is a life-saving intervention with excellent long-term outcomes that is delivered to almost 1000 patients across the UK each year by just seven liver transplant centres. The success of the programme means there are now over 12 000 liver recipients in need of ongoing specialist care. This rising number, together with the inevitable geographical inequality from such a small number of centres, has driven a number of network initiatives to provide many aspects of transplant care closer to patients. We have assessed the role of networks from published work and described the network arrangements for the South West (SW) region. Using National Health Service Blood and Transplant (NHSBT) records, we have confirmed that risk-adjusted medium and long-term survival data post-listing and post-transplant for patients cared for as part of this SW network are at least as good as for those cared for by a transplant centre. We have included a patients’ reflection on how the network positively impacts their care and how multiprofessional working can help support excellent outcomes. Networks can help deliver excellent clinical outcomes for patients who had liver transplants, wherever they live. Transplant units, if they have not already done so, should be looking at how they can involve regional centres within their catchment to help ensure all patients get the support and care they need as close to home as possible. In so doing, they will also help develop the future workforce needed to sustainably look after the growing cohort of liver recipients.