Referral and Listing:
If you are a physician and feel that your patient has end-stage organ disease and could benefit from an additional assessment, you may refer him or her for a consultation with London Health Science Centre's Multi-Organ Transplant Program (MOTP). Patients may be referred from the London region, the province of Ontario, or from across Canada.
Please note: As a result of the ongoing shortage of donated organs, the Multi-Organ Transplant Program can only offer transplantation services to patients who are full-time residents of Canada (Canadian citizens or those with landed immigrant status) who have current coverage with the provincial health insurance plan (OHIP).
If you are a physician with a patient who might benefit from a liver transplant, please fax the following information to the Liver Transplant Team at 519-663-3858:
- summary of patient’s illness and past medical history, investigations, laboratory results, U/S, CT scans, endoscopy/colonoscopy findings, medication list, height, weight
- patient demographics, including health card, address & phone number
We will contact the patient directly to schedule an outpatient assessment, which will be done over several days. A copy of the patient’s assessment schedule will be faxed to your office.
If the patient is in a hospital or very ill, please contact the on-call hepatologist at 519-685-8500 to discuss possible transfer to London Health Sciences Centre.
The following are guidelines and listing guidelines and a standard referral form as developed by Ontario's Trillium Gift of Life Network and Ontario's Liver Transplant Programs.
- Ontario's Referral and Listing Guidelines for Liver Transplant
- Liver Transplant Referral Form
- Ontario Clinical Handbook for Liver Transplantation
Vaccines should be completed prior to transplantation but this is not always possible depending on patient's length of time on the wait list or severity of illness. Below is an FAQ explaining all necessary vaccines as well as a proposed schedule for vaccinating. If there are any concerns or difficulties with vaccinating your patients, do not hesitate to contact the transplant program at LHSC.
LHSC Guidelines and Protocols:
The following guidelines and protocols were developed by LHSC's Liver Transplant Team and are specific to the care of LHSC liver recipients. They may not be applicable for care of recipients transplanted or being followed by other centres.
Following liver transplantation, recipients will continue to be followed by the LHSC Liver Transplant Team. Out of province recipients may be referred back to their local provincial program. Any community health care professionals with questions regarding the care of their patients are encouraged to contact the Transplant Team. For urgent issues, any member of the team can be contacted through the hospital switchboard, 519-685-8500.
- Vaccinations and Transplantation – Recommended Schedule and Information for Recipients
If recipients were unable to get vaccinations pre-transplant, they should be given post-transplant.
- Immunosuppression Guidelines
- Prophylaxis Management Guidelines (Fungi, CMV, HBV, Pneumocystis)
- Tumour Surveillance Post Transplant
- HCV Positive Donor Organs - Post-Transplant Follow-up
The following include information sheets for all common transplant medications used at LHSC. Recipients are provided with this information following their transplant. The LHSC Transplant Pharmacist is available to answer any further questions and can be contacted by email at email@example.com. For urgent issues, any member of the team can be contacted through the hospital switchboard, 519-685-8500.
Every patient being assessed for a liver transplant at LHSC has a physiotherapy assessment and will be provided with an exercise program as indicated by that assessment.
- LHSC Liver Frailty Assessment Algorithm
- Liver Frailty Index (University of California San Francisco)
Following transplant, all patients will continue to be followed by physiotherapy to assure optimal chest status and progression of mobility. All liver transplant recipients are provided with a home exercise program and additional resources if indicated.
If you have any questions regarding your patient's rehab program, please do not hesitate to contact our physiotherapy team at firstname.lastname@example.org.
The following are some of the resources provided to LHSC liver transplant recipients during their assessment, waiting and post-operative transplant periods. A list of all patient resources can be found under Patient Resources.