Advanced chronic liver disease (cirrhosis)

What we do

Advanced chronic liver disease (ACLD) includes advanced liver fibrosis and cirrhosis. It occurs when the amount of scar tissue (called fibrosis) builds up and affects the way the liver looks and functions. Fibrosis can be caused by many different liver diseases (for example metabolic liver disease, alcohol related liver disease, virus and autoimmune diseases).

People with ACLD are at risk of “decompensation”, where the liver is not capable of performing all of its normal functions.

The ACLD team provides the specialist input needed to diagnose and manage the symptoms of liver disease, working in continual partnership with your local gastroenterology or hepatology teams, GP and community services.

Our team will help you access specialist treatments for your liver disease when you need them.

We discuss all patients referred to the ACLD service in a multidisciplinary meeting.

Depending on the outcome of this meeting, we aim to see patients as soon as possible after referral. We then discuss with you, at your clinic appointment, options for management of your condition.

Common complications of ACLD we manage are:

• ascites (fluid build-up in the abdomen)
• encephalopathy (the effect of liver disease on brain function)
• varices and bleeding (swollen veins in the gullet and stomach which can cause bleeding)
• malnutrition (weight loss which is associated with advanced liver disease)

Patient information is also available from the British Liver Trust.

Preparing for your appointment

Your local hospital or GP will refer you to our service and will enclose in their referral to us all relevant recent blood tests and investigation results.

Please bring a copy of your current medications with you and any letters you have received from specialists you have seen in the past.

Please try and think of the main questions you would like answered when you come to your appointment and write them down before you come so we can answer them for you.

Research

We are always trying to improve the care and the clinical outcomes of patients with ACLD. One way to do this is to use the most up-to-date medications or interventions in the setting of a clinical trial, and there are usual multiple trials running within the service. We will always try to invite you to take part in research that may be suitable for you. Taking part is completely voluntary.

Some of these studies are designed as ‘randomised controlled trials’ to evaluate whether a newer treatment is more effective, and these trials will often include a placebo or ‘dummy drug’ to compare to. If you decide to take part, we will always seek your permission first so that you and your family and carers have an opportunity to ask questions and have any concerns addressed by our research team. You will also be provided with written information.

We also carry out observational studies to better understand disease processes in our patients with ACLD, in order to improve diagnosis, identify new treatments and to find better ways of managing this condition. These studies involve the collection of samples including blood, saliva, urine or stool of patients with ACLD, and we will always aim to combine any study visits with your clinic appointments to make it as easy as possible for you to take part. If you are interested, please ask your clinical team.

Location

Suite 9, Third Floor, Golden Jubilee Wing, King’s College Hospital, Denmark Hill, London, SE5 9RS

Contact Details

• Main Reception: 020 3299 3654
• ACLD service: [email protected]
• First outpatient appointment: 020 3299 1919
• Follow-up appointments: 020 3299 4979
• Follow-up appointments email: [email protected]

Patient information leaflets