For referrer use only and is not intended for patients to self-diagnose. Any patients who feel they may require a referral must be assessed and referred by their GP if appropriate.
If you are a GP or Specialist wishing to make a referral, please use the below contacts.
Urgent referrals: Contact the RNSH Switchboard (99267111) and ask to page the on-call gastroenterology registrar.
Routine referrals: Send referral letter via email to NSLHD-RNS-HepatologyService@health.nsw.gov.au or fax to (02) 9463 2041
Mandatory Referral Information: Please address referrals to a consultant being referred to in RNSH outpatients. If unsure, please refer to Dr. Cameron Gofton. All referrals must include a brief summary of the patients' condition, reason for referral, relevant medical history and medications. Any relevant pathology and other relevant test results should be included. Please advise if language translation services are required.
When to Refer:
Hepatology
- Cirrhosis (any cause)
- Chronic Hepatitis B
- HBeAg positive patients with ALT > 19 units/L (females) and > 30 units/L (males) AND HBV DNA >20 000 IU/mL
- HBeAg negative patients with serum ALT > 19 units/L (females) and > 30 units/L (males) elevated for 3 - 6 months AND HBV DNA >2000 units/mL
- Chronic Hepatitis C
- Anti-HCV Ab positive AND HCV RNA positive
- Non-alcoholic fatty liver disease with elevated ALT
- Alcoholic Liver Disease
- New liver lesion
- Other: abnormal LFTs for evaluation (note mandatory referral info below)
- Post-discharge patients
Urgent Referrals
- Decompensated cirrhosis: jaundice, ascites
- Liver cancer (hepatocellular cancer)
- Patients with positive HBV serology (HBsAg or anti0HBc positive) who are planned for chemotherapy/immunosuppression
- Pregnant women with abnormal LFTs or chronic hepatitis B (HBsAg positive)
Diagnostic Services
FibroScan - GP referral for firbroscan diagnostics are accepted for the following indicators:
- Chronic Hepatitis C (pre-treatment)
- Chronic Hepatitis B
- HCV-HIV co-infection
- Non-alcoholic fatty liver disease
- Alcoholic liver disease
- Primary Biliary Cholangitis
- Liver stiffness un-interpretable
- Acute hepatitis )ALT>10xULN)
- Extrahepatic cholestasis
- Right heart failure, hepatic congestion
Exclusion Criteria:
- Pregnancy
- Pacemaker, implantable defibrillator
- Cirrhosis already diagnosed by clinical, biochemical, &/or radiological methods; ascites
- Liver stiffness un-interpretable