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 can refer him or her for a consultation with London Health Science Centre's Multi-Organ Transplant Program (MOTP). Referrals may be referred from the London region, the province of Ontario, or from across Canada. ALD referrals are only accepted from patients within Ontario.
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). Patients should have current coverage with a provincial health insurance plan such as OHIP, or coverage through the Interim Federal Health Program.
Contact Information:
If you are a physician with a patient who might benefit from a liver transplant, please complete the LHSC Liver Transplant Referral Form and send the completed form to the Liver Transplant Team at:
- Fax: 519-663-3858
- Email: livertransplantreferral@lhsc.on.ca
Please include any, summary of patient’s illness and past medical history, investigations, laboratory results, U/S, CT scans, endoscopy/colonoscopy findings
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 via telephone 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.
Pre-Transplant Management:
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.
- Vaccinations and Transplantation – Recommended Schedule and Information for Recipients
Post-Transplant Management:
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 via telephone through the LHSC hospital switchboard at 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 PDF
- Prophylaxis Management Guidelines (CMV, HSV, Fungi, PJP and HBV)
- Tumour Surveillance Post Transplant PDF
- HCV Positive Donor Organs - Post-Transplant Follow-up PDF
Medication Information:
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 transplantmeds@lhsc.on.ca.
For urgent issues, any member of the team can be contacted via telephone through the LHSC hospital switchboard at 519-685-8500.
Physiotherapy:
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 PDF
- 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 transplantphysio@lhsc.on.ca.
Patient Resources:
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.