New research published today reveals a stark reality for people with chronic liver disease in England: despite facing a high risk of death after emergency hospital admission, the vast majority are not receiving a potentially life-saving liver transplant.
Published in the peer-reviewed journal Frontline Gastroenterology, a nationwide study of more than 82,000 patients found that only 0.64% received a liver transplant within a year of their first emergency admission, while nearly 38% died during that time.
The findings also reveal significant disparities in access to potentially life-saving treatment. Patients living in the most deprived areas were about half as likely to receive a transplant as those in the least deprived communities, and access varied depending on where people lived and the type of hospital they were admitted to.
People with alcohol-related liver disease — the most common cause of liver disease in the study — were less likely to receive a transplant.
Pamela Healy, Chief Executive of the British Liver Trust, who was one of the partners in the research study, said, “Today’s research highlights the difficult reality facing people with liver disease. Many reach crisis stage, are diagnosed for the first time during an emergency hospital admission to A&E, and then tragically end up dying only to have a life. The apparent inequalities associated with where someone lives with a transplant and their level of deprivation are deeply worrying and must be addressed.
Lead author Professor William Barnall, from King’s College Hospital Trust, added, “Our study shows that liver transplantation is used much less frequently than might be expected after emergency admissions for chronic liver disease, and that access is unequal. With such high mortality, there is an urgent need to improve both equitable access to transplantation and the overall care of these patients.”
The study also highlighted that patients hospitalized with transplant centers were significantly more likely to receive a transplant, underscoring the importance of timely referral pathways and access to specialist services.
Although liver transplantation can dramatically improve survival, researchers emphasize that the number of available transplants is limited. They call not only to address inequalities in access, but also to improve early detection of liver disease, prevent avoidable harm—especially from alcohol—and ensure better care during and after hospitalization.
Pamela Healy added, “Finally, we can’t rely on transplants alone. We need to do more to prevent liver disease, diagnose it earlier and ensure everyone has fair access to the care and treatment they need, wherever they live.”
Read the full study here: Liver transplantation in patients with chronic liver disease after emergency hospital admission in England: a nationwide study using a linked dataset Frontline Gastroenterology
