The proctor team

Very few transplant centres offer Living Donor Liver Transplantation (LDLT) for adult patients. Overall, living liver transplants account for only 2% of all living donor transplants in the UK. Most recipients are children.

NHS Blood and Transplant (NHSBT) is leading on a project to support the expansion of LDLT across the UK and, as part of this, an initiative to support the development of the programme for adult patients has just been launched. This involves bringing together a group of experts called a Proctor Team.

The proctor team will support the expansion of the programme so that more adults in need of a liver transplant (and more people who want to donate to them) have a chance to consider it, no matter where they live in the UK.

It includes senior transplant surgeons, liver doctors (transplant hepatologists), specialists in medical imaging (radiologists), anaesthetists and specialist nurses (living donor coordinators), all of whom are experts in LDLT and critical to the care and assessment of transplant recipients and living donors. They work in centres of excellence in the UK and are approved by NHS Blood and Transplant to be involved in the proctor team.

The proctoring model has been used successfully in other areas of surgery. Funding support from UK Transplant Commissioners has enabled a similar team to be set up to support transplantation for adults.

How will the proctor team work?

The proctor team provides a mobile expert team, collaborating with liver transplant teams across the UK.
If your local transplant team thinks that you could be a recipient of a living donor transplant or a possible living donor, they will refer your case to the proctor team. Recipients must be on the transplant list before being referred.

Whether you have your surgery in your local transplant centre or at a different one, the proctor team will follow your care and work with the transplant team throughout, from referral to your recovery from surgery.

Because living donor liver transplants for adults are rare in the UK, the proctor team will work with your transplant team according to the skills they need to develop. This will be different for every team, but it means that your team will follow a best practice pathway to donation or transplantation- regardless of where you live, or which centre you would usually be referred to for liver transplantation.

These standardised best practice protocols and pathways have been specially developed in collaboration with all liver transplant centres to support this programme, focusing on your safety – as either a living donor or as the recipient of a living donor transplant.

Before any LDLT surgery can go ahead, the proctor team must agree that it can proceed and NHSBT Organ and Tissue Donation and Transplantation (OTDT) Medical Director will sign-off the process that has been followed.

Will I be disadvantaged if my transplant centre is not performing LDLT surgery?

No. All donors and recipients referred for transplantation, will follow an approved pathway to donation or transplantation and receive the same standard of care regardless of where they live or which centre they would usually be referred to for liver transplantation.

How long will the proctor team programme be in place?

The original plan was to run the programme for 3 years, depending upon funding and how quickly centres could come on board. The proctor team meets monthly with NHSBT to review progress to plan and to monitor activity.