{
  "abstract": "Background In the UK almost 1000 patients benefit from liver transplantation annually with excellent long-term outcomes. Services are primarily delivered by seven transplant centres with no new centre opening since 1992 despite the ever-increasing number of successful transplants and the volume of post-transplant monitoring that is required for the 12,000 + liver recipients. This rising number, together with the inevitable geographic inequality from such a small number of centres, has driven a number of network initiatives to provide transplant care closer to patients.Methods The South-West Liver Unit (SWLU) established a formal network with Kings College Hospital (KCH) in 2004 which has evolved to offer transplant assessment and post-transplant care outside of the traditional specialist centre in a devolved care model. This has permitted specialist care to be provided locally to patients who may live as far as 300 miles from KCH, reducing the physical, financial and environmental impacts of frequent travel for patients and their families. Delivering specialist transplant care in this model must not be at the detriment of clinical outcomes. Data from the UK Transplant Registry was extracted (11.4.2025) to assess outcomes for patients from the SWLU compared to other centres.Results Between January 2006 and December 2023, 371 SWLU patients were listed and 297 progressed to transplantation. Risk-adjusted 1-, 5- and 10-year post-listing survival rates for SWLU patients were excellent at 88% (95% CI 85–91%), 79% (74–83%) and 67% (60–72%) respectively compared to national figures of 85% (85–86%), 73% (72–74%) and 61% (60–62%) – see table 1. Similarly, risk adjusted 1- and 5-year post-transplant survival rates for SWLU patients were 95.8% (95% CI 92.6–97.6%) and 88% (82.2–91.9%) compared to national figures of 93.5% (93–94%) and 82.3% (81.3–83.2%). Department of Transport data estimates the environmental impact of delivering care locally as a > 1000kg reduction in CO2 emissions for every patient in their first-year post-transplant alone. Table 1.Abstract P147 Table 1Risk-adjusted 1, 5 and 10 year patient survival from listing for adult1 elective first liver only registrations in the UK, 1 January 2006 – 31 December 2023 Centre Number of Patient survival (% (95% confidence interval)) registrations One year Five year Ten year Newcastle 655 86 (83, 88) 72 (67, 75) 59 (54, 63) Leeds 2045 83 (81, 85) 69 (67, 72) 57 (54, 60) Cambridge 1613 88 (87, 90) 78 (75, 80) 67 (64, 70) Royal Free 1643 85 (83, 86) 72 (70, 75) 60 (57, 64) King’s College2 2537 86 (85, 88) 74 (72, 76) 62 (59, 64) Birmingham 3060 83 (81, 84) 69 (66, 71) 57 (54, 60) Edinburgh 1439 88 (86, 89) 77 (74, 79) 64 (61, 67) South West3 371 88 (85, 91) 79 (74, 83) 67 (60, 72) TOTAL 13363 85 (85, 86) 73 (72, 74) 61 (60, 62) 1 Adult patients are defined as 18 years old and older 2 South West patients were excluded from the King’s College cohort of patients 3Patients with a Cornwall, Devon or Somerset postcode registered at King’s College transplant centre, excluding any patients from Bristol Royal Infirmary or Southmead HospitalDiscussion This data provides evidence that safe and effective delivery of specialist transplant care can be delivered using a specialist network model. It highlights that long term clinical outcomes are excellent whilst generating additional holistic benefits including a reduction in travel and the environmental impact of this as well as financial benefits. With the growing cohort of transplant recipients there is opportunity to expand this network model across all transplant centres to enable more patients to get the support and care they need as close to home as possible.",
  "authors": [
    {
      "affiliations": [
        "South West Liver Unit, University Hospital Plymouth Nhs Trust, Plymouth, UK"
      ],
      "name": "Nigel Keelty"
    },
    {
      "affiliations": [
        "South West Liver Unit, University Hospital Plymouth Nhs Trust, Plymouth, UK"
      ],
      "name": "Katie Ramos"
    },
    {
      "affiliations": [
        "South West Liver Unit, University Hospital Plymouth Nhs Trust, Plymouth, UK"
      ],
      "name": "Freya Rhodes"
    },
    {
      "affiliations": [
        "NHS Blood and Transplant Service"
      ],
      "name": "Rhiannon Taylor"
    },
    {
      "affiliations": [
        "Institute of Liver Studies, Kings College Hospital , London"
      ],
      "name": "Varuna Aluvihare"
    },
    {
      "affiliations": [
        "South West Liver Unit, University Hospital Plymouth Nhs Trust, Plymouth, UK"
      ],
      "name": "Matthew Cramp"
    }
  ],
  "title": "P147 Delivering excellent outcomes for liver transplant patients – the role of networks",
  "uid": "6eb36358-191a-5e54-a56d-da34806a543b"
}