Parker Richard, Holt Andrew
Leeds Liver Unit, St James's University Hospital, West Yorkshire, LS9 7TF, UK.
Clinical Director of Hepatology and Liver Transplantation, The Liver Unit, Nuffield House, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2GW, UK.
Alcohol Alcohol. 2018 Mar 1;53(2):145-150. doi: 10.1093/alcalc/agx103.
The UK has a socialized healthcare system that provides treatment that is free at the point of care for acute and chronic health disorders (the National Health Service-NHS), which is currently experiencing a period of unprecedented challenge.
A narrative review that discusses present and future arrangements for transplantation of alcohol-related liver disease (ArLD) in the UK.
Liver disease in the UK is reaching epidemic proportions due to obesity and metabolic disease compounding alcohol-mediated liver damage. Unfortunately, hepatology services in the UK are geographically disparate and subject to significant variations in liver morbidity and mortality, prompting concerns that this may negatively impair access to transplantation. In an attempt to improve referrals to tertiary liver services, the UK listing criteria for alcohol-associated liver disease were revised in 2016 by a working party under the aegis of the UK-Liver Advisory Group with the ambition of increasing opportunities for disease evaluation and improving the condition of candidates referred for assessment.
Liver transplantation for ArLD is well established in the UK. Recent organizational changes seek to reduce inequities in access to transplant services.
Liver disease in the UK is reaching epidemic proportions. Concerns over equity of access to liver transplantation prompted revision of the UK listing criteria for alcohol-associated liver disease in 2016, to improve to the availability of tertiary hepatology services. Transplanting patients with alcohol-related liver disease in the National Health System: New Rules and Decisions '…The second property of your excellent sherris is, the warming of the blood; which, before cold and settled, hath left the liver white and pale…'Falstaff; Henry IV Part 2: Act 4, Scene 3.
英国拥有社会化医疗体系，为急性和慢性健康疾病提供在护理点免费的治疗（国民医疗服务体系——NHS），该体系目前正经历前所未有的挑战时期。
一篇叙述性综述，讨论英国酒精性肝病（ArLD）移植的当前和未来安排。
由于肥胖和代谢性疾病加剧了酒精介导的肝损伤，英国的肝病正达到流行程度。不幸的是，英国的肝病服务在地理上分布不均，且肝发病率和死亡率存在显著差异，这引发了人们对这可能会对移植获取产生负面影响的担忧。为了改善向三级肝病服务机构的转诊，英国肝脏咨询小组主持下的一个工作小组于2016年修订了酒精性肝病的英国列入标准，旨在增加疾病评估机会并改善被转诊进行评估的候选人的状况。
在英国，ArLD的肝移植已成熟。最近的组织变革旨在减少移植服务获取方面的不公平现象。
英国的肝病正达到流行程度。对肝移植获取公平性的担忧促使英国在2016年修订了酒精性肝病的列入标准，以改善三级肝病服务的可及性。在国民医疗体系中为酒精性肝病患者进行移植：新规则与决策“……你那上等雪利酒的第二个特性，是能使血液变暖；在血液变得冰冷凝滞之前，它会使肝脏变得苍白……”福斯塔夫；《亨利四世》第二部：第四幕，第三场。
