A group of researchers of Sapienza University of Rome from the Department of Translational and Precision Medicine, Department of General Surgery, Surgical Specialities "Paride Stefanini" and Policlinico Umberto I General Hospital, in collaboration with the Centro di Epatologia e trapianto di fegato of the University of Tor Vergata and Innovo Consortium, presented the results obtained with a new online medical portal named "eReferral LT' - electronic Referral Liver Transplantation". The results have been published in the journal Clinical Gastroenterology and Hepatology.

The system can be accessed by any primary care practitioner or another specialist, who wishes to quickly and easily request an appointment with a liver transplant specialist (transplant hepatologist) to assess a patient's suitability for liver transplantation in an initial referral.

Unfortunately, traditional assessment methods do not allow efficient triage of potential liver transplant candidates. The research team investigated the effects of such criticalities, using a specially developed website for electronic patient referral. 

The portal can only be used in the case of elective liver transplantation, as the specialist's response is within 24/48 hours. It cannot be used in cases of acute liver failure or other situations requiring urgent referral.

Once connected to the portal, medical users choose the transplant centre to which they want to refer the patient and send the request with specific clinical documentation required by the website. The specialist on duty will be automatically notified by e-mail and can then book and communicate the appointment immediately or, if necessary, after interaction on the portal with the referring physician; appointments are issued on a case-by-case basis, depending on the clinical urgency of each patient.

This study demonstrates that using the eReferral LT portal alleviated the problem of low referral rates and late referral of potential candidates, mainly with liver cirrhosis or hepatocarcinoma, to liver transplant centres.

"With eReferral LT, the number of patients referred for transplantation has increased, improving the appropriateness of the visits requested," says Flaminia Ferri of Sapienza, the study's first author.

"The system identifies which medical visits are inappropriate," concludes Stefano Ginanni Corradini, the study's corresponding author and creator of the portal, "thus avoiding those visits and freeing up slots for more appropriate cases depending on the clinical urgency of each patient."

The portal's chat facility allows the referring physician and the transplant hepatologist to co-manage the patient also after the surgery.

References:

Electronic outpatient referral system for liver transplant improves appropriateness and allows first visit triage - Flaminia Ferri, Martina Milana, Aurelio Abbatecola, Alessandro Pintore, Ilaria Lenci, Simona Parisse, Alessandro Vitale, Gianluca Di Croce, Gianluca Mennini, Quirino Lai, Massimo Rossi, Roberta Angelico, Giuseppe Tisone, Alessandro Anselmo, Mario Angelico, Stefano Ginanni Corradini - Clin Gastroenterol Hepatol. 2021 DOI https://doi.org/10.1016/j.cgh.2021.10.005

Further Information

Stefano Ginanni Corradini
Department of Translational and Precision Medicine
stefano.corradini@uniroma1.it

Flaminia Ferri
Department of Translational and Precision Medicine
flaminia.ferri@uniroma1.it