Hepatology and Liver Transplantation Medicine Services at Flinders Medical Centre

The South Australian Hepatology and Transplant Medicine Unit (SAHTMU) based at Southern Adelaide Local Health Network (SAHLN) provides a comprehensive range of quaternary, and tertiary admitted, non-admitted and community services within the Hepatology service.

The unit is primarily based at Flinders Medical Centre (FMC) and provides inpatient, outpatient and outreach services to the SALHN catchment and designated country areas, including outreach services in Mount Gambier, several First Nations communities, and the Northern Territory (NT).

The following coordinated care programs exist for patients between the Hepatology service and the community:

  • GP Plus clinics (Noarlunga, Aldinga and Marion)

  • Indigenous clinics (Anangu Pitjantjatjara Yankunytjatjara (APY) lands, Yalata, Port Augusta and Coober Pedy)

  • Viral hepatitis program

  • Hepatitis outreach program (indigenous and regional)

  • Chronic liver failure programmes (stable and unstable)

  • Liver transplantation program

  • Hepatocellular carcinoma (HCC) program

  • Metabolic dysfunction associated fatty steatotic liver disease (MASLD) program

  • Home albumin program

  • Long-term abdominal drain program

The unit provides statewide services for both liver transplantation, complex HCC and end stage liver care. It is an integral part of the SA Liver Transplant Unit, providing inpatient and outpatient care for pre- and post-liver transplant patients statewide, including patients in the NT.

Consultant Hepatologists

Assoc Professor Kate Muller (Clinical Head of Unit)
Professor Alan Wigg (Academic Head / Matthew Flinders Professor)
Assoc Professor Jeyamani Ramachandran (Transplant Head)
Dr Alex Rodgers
Dr Darren Mounkley
Dr Yasmina Tashkent
Dr Madeline Gill

Visiting Consultant Hepatologists

Dr Marcus Teo
Dr Tsai Ow
Dr Damien Harding

Inpatient services

Located at FMC, admissions can either be emergency or elective. Elective admissions may include:

  • Liver transplant assessment
  • Large volume paracentesis
  • Transarterial chemoembolization (TACE) and microwave ablation

Outpatient clinics

Specialist led outpatient clinics occur at FMC, GP Plus Marion and GP Plus Noarlunga. This may include investigation and management of patients with liver disease, in particular unstable chronic liver disease, including cirrhosis and non-cirrhotic chronic liver diseases, hepatocellular carcinoma and pre-and-post-liver transplantation.

Hepatology nurse outpatient clinics are nurse coordinated programs that operate at FMC and GP Plus Aldinga, Marion and Noarlunga, and Mount Gambier. A substantial proportion of the outpatient workload is co-managed by Hepatology nurses who provide case management to stable and unstable patients. This may include:

  • Unstable patients with decompensated chronic liver disease
  • Viral hepatitis (B and C) outpatient management
  • Screening and surveillance of patients with chronic liver disease
  • Day-case paracentesis
  • FibroScan services (provided annually on cirrhotic patients)
  • MASLD assessments
  • Arranging albumin infusions

Indigenous Australian Outreach Services

The unit provides outreach services to Indigenous Australian populations at the APY lands, Yalata, Coober Pedy, Port Augusta and surrounding areas. Consultant Hepatologists travel to these locations and provide outpatient consultations as well as FibroScan, and ultrasound in locations where that service is not otherwise available. This activity provides much needed services to a population with significant burden of risk factors for liver disease, and liver disease including HCC.

Discharge/On-referral

Patients are discharged to other specialists or back to the community for management in primary care (this includes co-management with GPs). The unit has co-designed management pathways with GPs and provides supervision to support GPs in the management of early-stage MASLD and alcoholic liver disease (ALD).

Hepatology Nurse Consultants

Hepatology nurse consultants provide a range of specialist care coordination and support to liver disease patients and liver programmes, including the GP co-management pathways in viral hepatitis and liver cirrhosis, and Fibroscan clinics.

Email: Healthfmcchronicliver@sa.gov.au
Telephone: (08) 8204 6989 / 0466 792 661
Fax: (08) 8204 3035

Liver Transplant Coordinator Nurse Consultants

Liver Transplant Coordinators work with Hepatologists and Liver Transplant Surgeons to provide specialist care coordination and case management for SA/NT transplant patients during their assessment, waiting list and post-transplant periods. They also provide an on-call service to coordinate organ donor retrieval and liver transplant surgery.
Email: HealthFMCLiverTransplant@sa.gov.au
Telephone: (08) 8204 5819
Fax: (08) 8204 6959

Clinical Research Team

The hepatology unit has a strong research focus encompassing both commercially sponsored clinical trials and investigator-initiated research, particularly in chronic liver disease, HCC and indigenous health.

The unit has a Hepatology Fellow engaged in clinical research.
Sponsored Clinical Trials: Libby Cagney and Xiaohui (Cissy) Chen
Investigator led research: Dr Sumudu Narayana and Kathleen Davy

Refer your patient

To refer your patient, complete and fax a referral to us. Referrals are received from GPs and other specialist disciplines. Transplant referrals are only received from Hepatologists. Please use a named referral to a consultant listed above.

Outpatient Referral Criteria
Category 1

  • Decompensated liver disease
  • Suspected liver malignancy
  • Liver disease/hepatitis B virus (HBV) in pregnancy
  • HBV and about to start chemotherapy (unless antiviral already started)
  • Transplant referral
  • Severe acute liver injury
  • Jaundice

Category 2

  • All other

Frequently referred conditions for Hepatology are outlined on the SA Health CPC website (see Hepatology Outpatients - CPC | SA Health). CPCs are continually developed and updated across specialities.

Patients who are unstable and requiring immediate assessment should be sent directly to the Emergency Department.

All referrals are triaged by the service according to clinical urgency. To ensure appropriate and timely triage, include all demographic and clinical details as well as relevant investigation results.
For urgent referrals, if you are concerned about any delay of the appointment or if there is any deterioration in your patient’s condition, contact the Liver Registrar or Consultant on-call via the hospitals' switchboard telephone: (08) 8204 5511.

To make a referral

Fax: (08) 8204 3943
Telephone: (08) 8204 6869

Department contact details

Clinical Head of Unit - Assoc Professor Kate Muller
Secretary - Bridie Greaves
Telephone: (08) 8204 6869
Fax: (08) 8204 3943