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BC Liver transplantation: Sharing new evidence-based practice

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Vancouver The BC Liver Transplant Program is using new research to change its practice for liver transplantation. New, emerging clinical evidence prompted our liver transplant experts to review the current requirement to abstain from alcohol for six months before a liver transplant.

As in the past, being a good candidate for liver transplantation depends on consideration of overall physical health condition, emotional well-being and care plan management.  The new approach offers the potential treatment option of liver transplantation for those who have abstained from alcohol for less than six months and are regarded to have low-risk of post-transplant alcohol use once assessed by the transplant team. A period of abstinence from alcohol is still needed because the natural recovery of liver function can occur, reversing the need for a transplant.

BC Transplant is committed to ensuring that this new practice is shared with those who refer patients, as well as with the broader community. BC clinicians who refer patients for liver transplantation have been sent a notification reflecting this update. They have been informed that six-months of abstinence is not specified; the transplant program is ready to assess any individual regardless of their abstinence period if they continue to deteriorate.

Since the transplant program began 30 years ago, clinical guidelines support but do not dictate patient care. Medical professionals and specialists make appropriate care decisions about individual patients beyond the guidelines, based on their expert assessments.

BC has a culturally and socially diverse population. As health care providers, we are dedicated to serving all our patients and to recognizing challenges people may face with their health and well-being on a daily basis. With respect to alcohol and substance use, those working in programs and services across the Provincial Health Services Authority, including BC Transplant, appreciate there is an urgent need to help de-stigmatize alcohol use disorder and to encourage those who cannot reduce their alcohol consumption to seek support and treatment.  Collectively, we are eager to do our part with compassion and respect.

Transplantation would not be possible at all without the huge generosity of donors and their families. More than 700 people are waiting for an organ transplant in BC, and the need remains strong. Great care is taken with every decision to transplant, recognizing and respecting this precious gift of a donated organ by donors and their families.

The Provincial Health Services Authority plans, manages and evaluates selected specialty health care services across BC, working with the five regional health authorities, First Nations Health Authority and the Ministry of Health to deliver province-wide solutions that improve the health of British Columbians. For more information, visit www.phsa.ca or follow us @PHSAofBC.

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