New research highlights stark inequalities in access to life-saving liver transplants

Important new research published 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, the nationwide study of over 82,000 patients found that just 0.64% received a liver transplant within a year of their first emergency admission, while nearly 38% died in that time.

The findings also expose significant inequalities in access to potentially life-saving treatment. Patients living in the most deprived areas were around 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 the least likely to receive a transplant.

Pamela Healy, Chief Executive of the British Liver Trust, who were one of the research study’s partners, told That's Health: “This research lays bare the stark reality facing people with liver disease. 

"Too many are reaching crisis point, being diagnosed for the first time during an emergency hospital admission in A&E, and then, sadly, dying. 

"Only a tiny proportion go on to receive a life-saving transplant. The clear inequalities linked to where someone lives, and their level of deprivation are deeply concerning and must be addressed.”

Lead author Professor William Bernal of King’s College Hospital Trust added, “Our study shows liver transplantation is used far less often than might be expected after emergency admission with chronic liver disease, and that access is uneven. With such high mortality, there is an urgent need to improve both equitable access to transplantation and the overall care these patients receive.”

The study also highlights that patients admitted to hospitals with a transplant centre were significantly more likely to receive a transplant, underlining the importance of timely referral pathways and access to specialist services.

While liver transplantation can dramatically improve survival, the researchers emphasise the number of transplants available is limited. They call for action not only to address inequalities in access, but also to improve early detection of liver disease, prevent avoidable harm, particularly from alcohol, and ensure better care during and after hospital admission.

Pamela Healy added, “Ultimately, we cannot rely on transplantation alone. We must do much 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: https://fg.bmj.com/content/early/2026/05/28/flgastro-2026-103636

https://www.britishlivertrust.org.uk

British Liver Trust launches campaign to tackle late diagnosis of rare liver conditions

The British Liver Trust has launched a new campaign ahead of Rare Disease Day to tackle the late diagnosis of rare liver conditions, after new analysis of patient survey data revealed that many people experienced symptoms before diagnosis. 

Yet around a quarter of symptomatic patients had their concerns dismissed or were sent home without further investigation.

Liver disease is often associated with alcohol or lifestyle factors. But many rare liver conditions are autoimmune or genetic, affecting people of all ages, including babies, children and young adults. 

This misconception can contribute to delays in diagnosis and prevent people from seeking timely support.

Analysis of responses from more than 1,000 people living with rare liver conditions across the UK found that around one in five patients who experienced symptoms were diagnosed “very late”, when their disease had already progressed and treatment options were limited.

In response, the British Liver Trust has launched No One Left Behind, a new campaign aimed at shining a spotlight on rarer liver conditions that are too often under-recognised and misunderstood.

The campaign calls for greater awareness of early warning signs among healthcare professionals and the public, improved information and support at diagnosis, and greater investment in research.

Persistent itching, nausea, abdominal pain and jaundice were among the most commonly reported early warning signs across rarer liver conditions, including Primary Biliary Cholangitis (PBC), Autoimmune Hepatitis (AIH) and Primary Sclerosing Cholangitis (PSC). These are chronic, progressive diseases that often require lifelong specialist care. In some cases, delayed diagnosis can lead to cirrhosis, liver failure or the need for transplantation.

According to the British Liver Trust, tens of thousands of people in the UK are living with rare liver diseases, many of which can take years to diagnose due to a lack of awareness and limited research.

Emma was diagnosed with autoimmune hepatitis more than two decades ago, aged just 17, after developing severe itching and jaundice and spending weeks in hospital undergoing tests. At the time, she had never heard of the condition and did not recognise that her symptoms were signs of serious liver disease.

Emma told That's Health: “So many people don’t realise liver disease doesn’t just affect people who drink alcohol. Conditions like mine are called ‘rare’, but they affect thousands of people.”

Rare Disease Day is marked globally each year on 28 February and aims to raise awareness of rare diseases and improve access to diagnosis, treatment and care for those affected.

Pamela Healy OBE, Chief Executive of the British Liver Trust, added: “Rare liver diseases may be less common, but for the thousands of people affected across the UK, their impact is life-changing. Too often, a lack of awareness leads to delayed diagnosis and unequal access to specialist care. 

"We need greater understanding, earlier diagnosis and sustained investment in research to ensure no one living with a rare liver condition is left behind.”

The British Liver Trust is the UK’s leading liver health charity and provides information, support and advocacy for everyone affected by liver disease. This includes people living with rare liver conditions such as autoimmune hepatitis, primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), Alagille syndrome and biliary atresia.

For more information, visit www.britishlivertrust.org.uk.

October is Liver Cancer Awareness Month – Know the Signs, Save a Life

Every October, Liver Cancer Awareness Month shines a much-needed spotlight on one of the UK’s fastest-growing cancers. 

It’s a month dedicated to education, prevention, early detection, and supporting those affected by liver cancer.

While it doesn’t always get the same attention as other cancers, raising awareness can help save lives — because when caught early, liver cancer can often be treated far more effectively.

Understanding Liver Cancer

Liver cancer develops when abnormal cells grow uncontrollably within the liver. The most common type is hepatocellular carcinoma (HCC), usually linked to existing liver damage such as cirrhosis or hepatitis infections.

The liver performs hundreds of vital functions — from detoxifying the body to processing nutrients — so when it’s under threat, the consequences can be serious. Because it can regenerate, damage isn’t always obvious until the cancer is advanced, making early awareness and regular health checks essential.

Learn more:

British Liver Trust – Understanding Liver Cancer https://britishlivertrust.org.uk

The Rising Number of Cases

According to Cancer Research UK, liver cancer rates in the UK have more than tripled since the 1970s. Each year, around 6,100 people are diagnosed, and cases are expected to continue rising.

The worrying statistic is that most cases are diagnosed late, when treatment options are limited — but awareness and proactive health care can change that.

Major Risk Factors

Certain lifestyle and health factors increase the likelihood of developing liver cancer:

Chronic hepatitis B or C infections

Excessive alcohol intake

Non-alcoholic fatty liver disease (NAFLD), often linked to obesity or type 2 diabetes

Cirrhosis (from any cause)

Smoking

Family history of liver disease

The positive news is that many of these risk factors are preventable or manageable. Reducing alcohol consumption, maintaining a healthy weight, getting vaccinated against hepatitis B, and seeking treatment for hepatitis or liver disease can all make a significant difference.

NHS – How to Keep Your Liver Healthy https://www.nhs.uk/conditions/liver-cancer

Warning Signs to Watch Out For

Liver cancer is often called a “silent disease” because symptoms may not appear until it’s advanced. If you notice any of the following, book an appointment with your GP:

Persistent tiredness and weakness

Unexplained weight loss

Loss of appetite

Pain or swelling in the upper right side of the abdomen

Jaundice (yellowing of the skin or eyes)

Pale stools or dark urine

Nausea or vomiting

Early diagnosis gives the best chance of successful treatment. Don’t ignore changes in your health — getting checked could save your life.

NHS – Liver Cancer Symptoms and Treatment https://www.nhs.uk/conditions/liver-cancer

Supporting Liver Cancer Awareness Month

Throughout October, charities and organisations across the UK are working to raise awareness, fund research, and support those living with liver cancer.

Here’s how you can help:

Wear a green ribbon to show support.

Share awareness posts on social media using hashtags like #LiverCancerAwarenessMonth.

Take part in fundraising events organised by the British Liver Trust or Liver Cancer UK https://livercanceruk.org

Encourage family and friends to get regular check-ups if they’re at risk.

Final Thoughts

Liver cancer awareness isn’t just about statistics, it’s about real people, real families, and real lives that can be saved through knowledge and action. This October, let’s help spread the message: know the risks, know the signs, and protect your liver health.

If you’re concerned about your risk or symptoms, please speak to your GP or contact:

📞 British Liver Trust Helpline – 0800 652 7330

📞 Macmillan Cancer Support – 0808 808 00 00

People missing out on life-saving liver cancer checks, experts warn

New UK guidance published in Frontline Gastroenterology and being presented this week at the UK’s leading liver conference reveals a serious gap in care, with estimates suggesting only around one in five patients who are eligible for liver cancer surveillance attend regularly. 

Experts worry this could have major consequences for early detection and survival.

The paper, Hepatocellular Carcinoma Surveillance: Minimum Standards, sets out new national standards for how liver cancer surveillance should be delivered across the NHS. Despite clear recommendations for regular monitoring, it's estimated a significant number of patients at risk are not consistently taking part in surveillance programmes.

Most people who develop hepatocellular carcinoma (HCC), the most common type of primary liver cancer, already have liver disease. 

Cirrhosis is present in up to 90% of cases. The main causes include viral hepatitis, alcohol-related liver disease and, increasingly, metabolic dysfunction-associated steatotic liver disease (MASLD) linked to rising obesity rates in the UK.

Early detection through regular checks is vital. When liver cancer is found early, curative treatments such as surgery or ablation are often possible. However, the current low uptake means many people are still diagnosed at a later stage, when treatment options are limited and outcomes are poorer.

“Effective surveillance saves lives,” Professor Stuart McPherson, lead author of the guidance and consultant Hepatologist at Newcastle Hospitals told That's Health.

“But too many patients are missing out. These minimum standards are designed to make sure that everyone at risk is identified, followed up and supported to stay in the system.”

The guidance highlights several reasons why patients may not attend regularly. These include fear of a diagnosis, stigma, and difficulties understanding medical letters. Practical issues also play a role, such as challenges in accessing scans, the absence of recall systems, and the lack of a national liver cancer registry.

Vanessa Hebditch, Director of Policy, at Liver Cancer UK, part of the British Liver Trust, said: “Liver cancer is the fastest rising cause of cancer death in the UK. Finding people with an early stage of liver cancer is vital to ensure that they receive treatment as soon as possible.

“The fact patients may be missing out on regular surveillance is deeply concerning. We need to tackle patient and system barriers so that no one slips through the cracks.”

The new standards call for reliable systems to identify and recall at-risk patients, clear communication using plain language, timely access to follow-up scans and stronger coordination between NHS liver services.

The guidance has been discussed at the British Association for the Study of the Liver conference taking place in Belfast between 8th and 10th October, today.

“This is a call to action for liver services across the UK,” continues Professor McPherson. “Surveillance only works if people take part, and that means making it easier and more supportive for patients.”

The full guidance is available online in Frontline Gastroenterology: https://fg.bmj.com/content/16/e1/e34

https://britishlivertrust.org.uk