Liver Transplant Evaluation and Assessment Guide

Allied Health Services

Social worker

The social workers within the hepatology and liver transplant team can provide support at all stages of the assessment and treatment process to patients and families. This occurs through general discussion, shared information, counselling, education, and referral to other services. When referred to the Princess Alexandra Hospital for liver transplant assessment, an information package including a Social Work Intake Questionnaire is sent to all patients and their families by the liver transplant coordinators. This Questionnaire provides opportunity for patients and families to tell us about their life situation. A telehealth, usually by phone or in-person, social work clinic appointment occurs soon after the Questionnaire has been returned. This assists us to work out with you and your family what information and support would be most useful at this time.

Having been told they may need a liver transplant, many patients and families describe feeling anxious or overwhelmed as the prospect of a transplant is a totally new experience for them. There can be uncertainty about many things. Concerns and questions often centre around where to stay, how to manage income and expenses or how to address advance care planning and legal matters, for example, an Enduring Power of Attorney, Will, and an Advance Health Care Directive or Metro South Statement of Choices.

Often patients are worried about how their family members, especially young children; might be feeling and coping. For many people, preparing and waiting for a liver transplant can contribute towards changed family and personal relationships, employment, day to day activities and place of residence, you may need to move to Brisbane.

There is often much anticipation around the possibility of receiving a liver transplant, yet grief and worry that the liver is failing and the patient is getting sicker. It can be very tough on everyone in the family. The social worker can provide support and care throughout this time to patients and their families.

The transplant process is physically, medically, emotionally and personally demanding; therefore clear criteria must be met to be placed onto the waiting list for a transplant. Even though transplantation is a well-known treatment with stories about organ donation and transplants often featuring in mainstream and social media; unfortunately, it is not for everyone. If the team is unable to list you for a transplant, your options will be sensitively and carefully discussed with you and your family.

Patients and families are very welcome to make an appointment with the social worker at any stage of the treatment process for information, support, counselling or referral to another support service.

Advance Care Planning

https://www.qld.gov.au/health/support/end-of-life/advance-care-planning

Phone: 07 3176 2617 - leave a voicemail message
Email: pahlivertransplant.sw@health.qld.gov.au

Dietitian

The transplant dietitian will provide a complete nutritional assessment. This is to determine your nutritional status, level of physical function and identify any dietary risk factors for surgery. Your diet will be assessed to determine whether changes are needed and nutritional supplement drinks will be recommended if necessary. You will be followed up by the dietitian until your transplant, and also after your transplant.

Dentist

All patients undergoing transplant assessment need a full check up with their dentist. The mouth can hold many bacteria and some of these bacteria can cause infections in the post-transplant period. Please ensure you speak to your doctor to organise antibiotic cover for any dental treatment. If you need teeth removed this may need to be done as an inpatient due to bleeding concerns. Please discuss with the liver transplant team.

Pastoral Care

Pastoral carers are available for the spiritual and religious care of patients and their families. Pastoral care is available during office hours and on call at other times for inpatients. If you would like to be visited by a member of your faith, please ask the staff to contact them for you. The Worship Centre is situated on the ground floor of building 1, opening hours 6.30am to 9pm daily.

Mental Health

Good mental health is incredibly important to our well-being, yet 20 per cent of the general population in Australia are affected by mental health issues in any one year. Poor mental health can show up in many ways. Some of these include low mood, depression, anxiety, sadness,

fear, loneliness, general unhappiness, lack of fulfillment, meaninglessness, insomnia, feelings of being out-of- control or of hopelessness, suicidal thoughts, phobias, schizophrenia, bipolar disorder, eating disorders and more. There is often a strong relationship between poor mental health, grief, and substance dependence. Unresolved mental health issues can contribute to housing, employment, relationship and other personal or social stress and crisis.

It is important that any past and present mental health concerns are identified. Patients often describe the huge relief in talking about and addressing their mental health, this sometimes being the first time they have done so. It is never too late or early to seek help for a mental health check. Compassionate and professional supports can be quickly put in place, achieving very helpful outcomes.

Occasionally, transplant recipients suffer significant psychiatric symptoms in the first few months after their operation such as depression, anxiety, mania, psychosis and body image issues.

The Liver Transplant team is supported by the Mental Health Service of the Princess Alexandra Hospital. Specialist mental health staff can provide assessment and treatment of mental health problems that may arise at any stage during the transplant process. Please discuss with your hepatologist or the liver transplant coordinator.

Mental health support PAH

Alcohol and Drug support

In this guide:

  1. Information and contact details for the liver transplant hepatology team
  2. The liver - its function and anatomy
  3. Signs of liver disease
  4. Pre-transplant assessment and evaluation
  5. The assessment team
  6. Allied Health Services
  7. Palliative care
  8. Pharmacy—medications before your transplant
  9. Case discussion and assessment presentation
  10. Will I make the list?
  11. The liver transplant waiting list
  12. Model for End stage Liver Disease (MELD)
  13. Support Through Education Program (STEP)
  14. The Donor
  15. What happens when you are notified that a donor liver is available?
  16. The liver transplant operation
  17. Intensive Care Unit (ICU) patient information
  18. The recovery period
  19. Pharmacy—medications after your transplant
  20. Rejection
  21. Donor family correspondence and information
  22. Glossary

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