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So far Arthur Goan has created 242 blog entries.

Remember our post in September on the Loch Ness Marathon?

Do you remember the post we put up about Damien running the Loch Ness Marathon in September of this year? Well he did it and raised a staggering sum of money to be distributed among three charities; one of which is the RVH Liver Support Group.

Mairead, Damien’s wife, received a life saving liver transplant approx five years ago and Damien wanted to give something back. Well, he has, by way of a donation amounting to ÂŁ3885.45. We would like to thank him most sincerely for this and we hope that Mairead continues to do well.

Remember our post in September on the Loch Ness Marathon?2023-01-07T04:30:16+00:00

LSG Visit to King’s College Hospital, London

Thankfully, after an enforced break due to Covid, we were able to revisit King’s once again in November, to renew acquaintances, establish new relationships and provide the staff there with updates on the Group as of 2022.

Kay and Jim spent four very full and rewarding days in London, during which they reviewed some of the accommodation used by patients and carers when they go for treatment – a very worthwhile exercise which allowed them to consider distances and travel options and times to King’s, and the availability of dining and other options nearby.

Considerable time was spent each day meeting with the transplant coordinators, consultants, surgeons, Todd Ward staff and others whom patients and carers might encounter during their time in King’s.  A meeting with some of the committee members from the LISTEN patient support group in King’s was most welcome, and much was learned on both sides around patient care, particularly concerning those patients from Northern Ireland.

Kay and Jim were also fortunate to be able to spend some time with a local patient who had been transplanted immediately before their visit, as well as his partner, and to call in with another local man who had returned to King’s for a post-transplant procedure.

Much was gained during the visit, thanks in no small way to the fantastic support provided by King’s Senior Social Worker, Paul McKie, and we look forward to being able to return again later in 2023.

LSG Visit to King’s College Hospital, London2022-12-28T11:22:59+00:00

🧑‍🎄The RVHLSG Santa Claus unit gets into gear for Christmas 🧑‍🎄

Committee members of the Liver Support Group have been out recently gathering up lots of pressies to make up hampers for the child, adolescent and adult liver patients who are currently in hospital. They have all been delivered over the past few days to the wards and we would like to take this opportunity to sincerely thank all of those involved in “Operation Santa” !!

🧑‍🎄The RVHLSG Santa Claus unit gets into gear for Christmas 🧑‍🎄2022-12-23T14:10:36+00:00

RVHLSG contributes to research costs at the RVH Liver Unit

The RVH Liver Support Group recently made a donation to the RVH Liver Unit as it investigates the possibility of bringing “Enhanced Liver Fibrosis” testing to N Ireland. In the article below Dr Leanne Stratton, a hepatology consultant in the RVH leading the research, explains what it all means for patients here.

About the ELF test

The “ELF” test is a blood test, also known as the “Enhanced Liver Fibrosis” test.  This blood test is a panel which measures 3 separate blood markers of scar damage (fibrosis) in the liver: hyaluronic acid (HA), procollagen III amino-terminal peptide (PIIINP), and tissue inhibitor of matrix metalloproteinase (TIMP-1).  This blood test panel isn’t currently available in Northern Ireland.

NICE Guidelines 2016

The ELF test was mentioned in NICE (National Institute for Clinical Excellence) guidelines for non-alcoholic fatty liver disease (NAFLD) in 2016 as a way to determine if there is any significant scar tissue in the liver.  One in four adults in Europe has evidence of fatty change in their liver, but not all of these patients will develop scarring in their liver secondary to fat, and not all will need seen by a hepatologist.

The NICE guidelines suggest that the ELF test may be used in adults who have a diagnosis of NAFLD to determine if there is any evidence of advanced fibrosis.  These guidelines suggest that, for patients who have an ELF score of 10.51 or above and NAFLD, they can be considered to have advanced fibrosis.  For patients with an ELF score of less than 10.51, they are unlikely to have advanced liver fibrosis, and should be reassessed at 3 yearly intervals.

Current practice in RVH Liver Unit

In the RVH Liver Unit, patients are risk-stratified using the “NAFLD score” – this is a blood panel score taking into account recent liver bloods, platelet count, body mass index (BMI) and presence of diabetes.  For patients who are “low risk” on this score, they can be managed in primary care, addressing any relevant risk factors (weight, high blood pressure, diabetes, high cholesterol or sedentary lifestyle).  For patients who are of “indeterminate” or “high” risk, they are generally offered a Fibroscan and a clinic appointment in the service.

Fibroscans and current challenges

One of the current challenges in the Liver Unit, is with regards to demands on the Fibroscan service.  The Fibroscan can be used across lots of different causes of liver disease to help assess for fibrosis.  Some conditions, such as chronic hepatitis B, require an interval Fibroscan every few years as per guidelines, which adds to the demand on the resource.  Our current waiting time for a routine Fibroscan in Belfast is in excess of two years.  Over 25% of patients who are waiting for a Fibroscan have NAFLD.  For many years, the only Fibroscan machine in Northern Ireland was in Belfast, and so our waiting list still holds patients from other Trusts who were referred before each Trust had their own scanner.

Another challenge of the Fibroscan can be the difficulty in obtaining accurate readings in patients who are morbidly obese – an increasing challenge that we face in our clinics.  There is also currently a four year waiting time for routine clinic appointments in the hepatology service – yet another challenge that we are aiming to address.

Potential solutions

We are keen to explore other ways to “risk-stratify” our patients, so that patients who are at the highest risk of significant fibrosis are seen quickly, and those who are low risk can be given appropriate lifestyle advice and discharged back to the care of their GP.  We are currently working on a pathway for new NAFLD referrals into the service, development of a nurse-led first assessment clinic for NAFLD, and educations sessions for GPs across Northern Ireland.  As part of this work, we have been keen to explore whether the addition of ELF testing would help to risk-stratify patients, to enable more timely access to the service to those in highest need, and to reduce demand on the Fibroscan service.

RVH Liver Support Group

We have been very grateful to the RVH Liver Support Group for a very kind donation of £2,000 in 2022 to run a pilot study of ELF test feasibility.  With collaboration between our laboratory scientists, phlebotomy hub, Ninewells (Dundee) biochemistry labs, and our specialist hepatology nurse Jessica Brown, we have been able to invite 40 patients with “indeterminate NAFLD” scores for ELF tests which cost £50 per patient.  This has only been possible with the support of the RVH LSG.  This pilot is currently underway and results will hopefully be available and collated by the end of January 2023.  This will allow us to assess whether the introduction of ELF testing will be of benefit in the risk-assessment of new NAFLD patients referred into the service.  If it appears to be useful, it will give us the information that we need to approach commissioners to ask for funding for this service for patients in Northern Ireland.

RVHLSG contributes to research costs at the RVH Liver Unit2022-12-23T12:19:28+00:00

Liver Support Group funds medical research

The Project Team L-R - Suzanne Lester, Sandra Lawler, Jim Kilpatrick, Stephen McNair, Alison McConville

As well as supporting patients with various liver conditions the Liver Support Group also provides funding for research into liver related issues with the outcomes of said research projects ultimately helping those living with liver problems.

Just recently the Group has offered funding to Suzanne Lester, the advanced Physiotherapy  Practitioner at the RVH Liver Unit, and this is her update….

Background

The PREPARE project began in October 2020 with an application to the Health and Social Care R&D Fellowship which was co-written by physiotherapist Suzanne Lester and 3 patients from the Northern Ireland liver transplant waiting list.  Approval was granted in February 2021, which enabled the PREPARE project to commence its 3-year journey.   The project team consists of 5 patients from the liver transplant community here in Northern Ireland, Suzanne Lester PhD Fellow and physiotherapist, Professor Judy Bradley, Dr. Bronwen Connolly and Dr. Johnny Cash.

Aim
The project aims to co-design and develop a remote prehabilitation (support) programme to help patients maintain their best health, body mass and muscle strength while on the transplant waiting list.

To achieve this the PREPARE project will deliver 4 studies.
1. Study 1 – a literature review which will consider the available literature to understand what the prehabilitation programme could include.
2. Study 2 – focus groups with patients, caregivers and clinicians.  These groups will provide an in-depth understanding of what patients’ caregivers and clinicians feel the remote prehabilitation programme should include in order to support and help patients through the transplant waiting period.
3. Study 3 – co-design workshops where Suzanne Lester the researcher together with patients, caregivers and clinicians will develop the prehabilitation programme.
4. Study 4 – delivery of the intervention to a selection of patients who are on the waiting list.

The Liver Support Group have been integral to the progress of this research to date by helping to recruit patients from both NI and the UK to the PREPARE study.  They have also very generously donated funds to provide an online programme to allow the intervention to be delivered remotely.  Their support has been invaluable and will be crucial in progressing the project to the next stage of the co-design workshops.

Liver Support Group funds medical research2022-12-23T11:50:11+00:00

Our children & young people patient carers visit Birmingham

Birmingham Children's Hospital

From right to left - Dr Girish Gupte, Rachel (LSG Patient Care), Stacey Watson, Lesley Roach & Patricia (LSG Patient Care).

Our children & young people patient carers Patricia and Rachel were delighted to accompany RBHSC specialist nurses Stacey Watson and Lesley Roach on a 3 day visit to Birmingham Children’s Hospital  liver unit from 9th to 11th November. The much-anticipated trip through the long months of covid restrictions, was finally able to go ahead and has proved as beneficial as hoped for.

Meeting with professionals from the multi-disciplinary liver team from clinicians, nurses, physiotherapist, psychologist, play therapists, family support and youth workers has given such an insight into the excellent care children and young people from NI with a liver condition are able to receive at Birmingham Children’s. Putting faces to names and seeing how that journey for families who find themselves on Ward 8 begins and develops has been invaluable.

With the intention and motivation for the visit being how the team at RBHSC and our liver support group could improve children and young people’s care here, the plans for new training opportunities for the Belfast team and the LSG facilitating virtual link ups between Birmingham staff and families here we look forward to reaping the benefits.

Following the trip Stacey and Lesley expressed their gratitude with the words below:

“ Just returned to work today after our trip with yourselves.

I just wanted to email to say Thank you so much for the amazing time we both had.

We hope to utilise everything we have learnt and this will only make the service here better for our children and families, this was such a useful trip. “

Our children & young people patient carers visit Birmingham2022-12-12T23:00:45+00:00

“Thank you note from Brendan”

A few weeks back one of our adult patient care staff made a call to Brendan to see how he was keeping. He is doing great and, during the call, he mentioned that he was celebrating 30 years as a transplanted person. Featured here, written by himself, is an expression of his deep gratitude to many of those who helped him along the way.

 

“I had a liver transplant in August 1992.  I was almost 47 years old then and had suffered an ongoing liver and jaundice problem from the age of 12.

I am forever grateful to the donor family who made this possible for me and literally saved my life.  I thank God for the medical staff at Kings College Hospital in London who performed the operation and took care of me afterwards.  I am also grateful for the support of my family especially my wife Carmel who was with me throughout caring for me and fighting my battles.   

For the last 30 years I have attended the liver clinic at the Royal Victoria Hospital Belfast where the consultants have kept me on the right dosages of immune suppressing drugs. I hope my story will encourage those waiting for a transplant, those recovering from a transplant and donor families.”

Kind regards,

Brendan Byrne

 

Sent from my iPad

“Thank you note from Brendan”2022-11-30T11:59:48+00:00

Birmingham Children’s Hospital Celebration touches our Rachel

Commuters to Birmingham railway station were greeted this morning with a beautiful mosaic celebrating 160 years of looking after sick kids. The 7m x 8m mosaic is located on the floor in the station’s main concourse. It depicts the red brick iconic building and is lovingly surrounded and adorned by over 850 images of young patients, past and present. It is particularly poignant to Rachel, one of our esteemed committee members, because it contains a picture of her late daughter, Lucia, who was treated there. In the larger picture (opposite) Lucia is featured at the bottom right of the mosaic and has been highlighted.

Please click on the link below to read the full story on the hospital that transplants all of our child and adolescent patients.

https://www.bch.org.uk/news/mosaic-installation-birmingham-new-street-station-birmingham-childrens-hospitals-160th-anniversary?utm_source=Twitter&utm_medium=social&utm_campaign=Orlo

Birmingham Children’s Hospital Celebration touches our Rachel2022-11-24T20:53:55+00:00

John, remembering a special life event……

.....celebrating his first liver transplant anniversary

Pictured above is John Hargan holding a collection at his local Spar in Portglenone. Thank you to John and everyone who donated the grand sum of ÂŁ1244.96.

John, remembering a special life event……2022-11-05T23:35:42+00:00
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