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Hepatology services

Level 3 - Ambulatory Care Centre (Check in B)

Acute Services Building

Royal North Shore

Reserve Rd

St Leonards

2065

Hepatology services

Contact us

Phone: 02 9463 2463

Fax: 02 9463 2041

eMail: NSLHD-RNS-HepatologyService@health.nsw.gov.au

Opening hours

  • Monday: 13:30 - 15:30
  • Wednesday: 8:30 - 11:30
  • Thursday: 9:00 - 11:00

Related services

 What we do

The Hepatology Service and its Liver Clinic at Royal North Shore Hospital provides specialist Hepatology consultations and multi-disciplinary care for patients within the Northern Sydney Local Health District. We manage patients with liver disease arising from hepatitis B, hepatitis C, non-alcoholic fatty liver disease, alcohol-induced and drug-induced liver injury, autoimmune and metabolic disorders.

 

The Hepatology Service provides comprehensive assessment and management of patients with primary liver cancers (hepatocellular cancer) and associated liver disease in the context of a multi-disciplinary framework with other medical specialties.

 

We provide treatment for:

  • Hepatitis B
  • Hepatitis C
  • Liver Disease
  • Liver Cancer

 

We care for and treat people with:

  • Cirrhosis
  • Chronic Hepatitis B and C
  • Non-alcoholic fatty Liver Disease
  • Alcoholic Liver Disease
  • New Liver Lesions

 What to bring

  • Images / Scans
  • Blood Results
  • List of current medications
  • Referral
  • Medicare card

 When to visit us

Basic investigations required for Liver Clinic Consultation:

  • LFTs, EUC, FBC, coagulation
  • HBV serology: HBsAg, anti-HBc, anti-HBs; if HBsAg positive, test HBeAg, anti-HBe and HBV DNA
  • Anti-HCV Ab; if positive, test HCV RNA(quatitative), HCV genotype
  • Liver ultrasound

 

Referrals with insufficient information will be returned to the GP until further information is provided to the clinic.
 


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

 How to visit us

Turn onto Palmerston Road from Edgeworth David Avenue. The Emergency entrance is just after the Burdett Street Intersection on the right. The Multi-storey carpark is further along after the Northcott Road junction.

Transdev bus 575 travels to Hornsby Ku-ring-gai Hospital from Hornsby and Turramurra railway stations. This picks up and sets down at the front of the Hospital on Palmerston Road. There are no buses to the Hospital from Waitara Station.

The closest railway stations are Hornsby and Waitara. Hornsby is accessible via both the main Northern Line and the North Shore Line. Waitara is on the North Shore Line. Transdev bus service #575 travels to Hornsby Ku-ring-gai Hospital from these stations.

From Hornsby Station – The distance to the Hospital is approximately 1.8km. If you wish to walk please note there are a number of hills. Exit the station on the George Street side via the pedestrian overpass.
From Waitara Station – The distance to the Hospital is approximately 1.5km. Exit the station on the Alexandria Avenue side. This walk is reasonably flat.

Hornsby Hospital has a multi-storey car park that offers 500 spaces and is located at Gate 2 (Palmerston Road). This carpark provides access for all areas across the campus.

Parking fees apply across the whole hospital in accordance with the NSW Health's hospital car parking fees policy and can be accessed here. Concessional rates apply to those who are eligible.

Disabled parking spaces are available in the multi-storey car park and also on Lowe and Palmerston Roads, though street parking availability is very limited. Your valid disabled parking permit must be displayed in your car at all times. Please do not park in restricted parking areas; you could be blocking access to emergency services.

 Referral information

  • GP referral
  • Medical referral

 

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: All Hepatology referrals must include a consultant being referred to in RNSH outpatients. If unsure, please refer to Dr. Brett Jones and associates. 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.

 Other information

 

Can transport be organised for people to attend?

Patients should arrange for their own transport for their clinic appointments.

 

Is there a cost to patients to attend the clinic?

No. Clinic appointments are free of charge for eligible Medicare card holders.

Non - Medicare card holders may be charged for consultation fees and including other related medical expenses.

 Related links