Pioneers in patient care: consultants leading change
Midlands
Innovation: The development and expansion of liver transplantation to become a safe and effective treatment of liver disease.
Professor Paul McMaster
Queen Elizabeth Hospital, Birmingham
Job title: Professor of hepatobiliary surgery & transplantation
Specialty: Hepatobiliary & transplant surgery
A handful of patients received liver transplants in the early Eighties. "Now more than 650 patients a year receive a liver transplant and the majority regain full health and normal activities,” says Birmingham Professor of Hepatobiliary Surgery & Transplantation Paul McMaster, who performed one of the first liver transplant operations and has pioneered the operation’s progress ever since.
Professor McMaster says: "This was a major development for patients facing a terminal illness with liver disease and cirrhosis and it has injected real hope. It was introduced to try and expand the opportunities to treat people, both young and old, and those with complex liver problems, rather than a tiny handful of selected patients."
The complicated operation can take many hours. Professor McMaster says: "Liver transplantation is a complicated operation because of the multiple blood vessels that run to the liver. The old, damaged liver is often very scarred and congested and it can be very difficult to remove and the replacement liver, the implantation, requires a lot of technical work to draw the blood vessels together."
The operation is further complicated because the new, transplant liver must work immediately as there is no comprehensive liver support machine and because many of the patient’s organs are not functioning properly because the liver is failing.
The innovation was funded directly through the health service via supra-regional funding and research grants. Its success has been measured by the number of patients treated and the increasing success of patients’ care, their quality of life and rehabilitation, says Professor McMaster.
He says that he and his multi-disciplinary team feel they have enough time to look after patients properly and over the past five years, additional government funding has been put into the unit. Although he adds that until recently "this work was my total life".
"For 15 years I worked 24 hours a day, seven days a week to solve the problems and with a very talented team around me we made it work."
"With more time we could reduce the waiting times and waiting lists and reduce failures," he says. "The critical resource is donor livers, as the number of organ donors has fallen by 20 per cent over the last decades. But at times shortage of theatre space and intensive care beds is also a critical issue.
"The integrated development of the National Liver Service and Transplantation would significantly enhance the service and be very welcome," Professor McMaster adds.
"I would certainly recommend medicine as a career. It can be enormously rewarding although at times massively frustrating."