Updated 25/05/2026
- Patient-centred care in liver transplantation requires institutional systems, not just individual effort, new analysis finds
- The complexity of liver transplantation: Why patient-centred care matters
- Five critical domains for patient-centred transplant systems
- Professionalism as an organisational responsibility
- Living donor protection: A cornerstone of ethical transplant care
- Frequently asked questions
- What does ‘patient-centred care’ mean in transplantation?
- Why is institutional responsibility more important than individual effort?
- What are the main risks for living donors in liver transplantation?
- How do accreditation standards support patient-centred transplant care?
- What comes next for Georgian transplant services?
Patient-centred care in liver transplantation requires institutional systems, not just individual effort, new analysis finds
As Georgia’s liver transplant services have expanded over the past decade, clinical capacity has grown—but systemic challenges in patient communication, continuity of care, and ethical oversight have emerged alongside it. A new analysis published in the Georgian Medical Journal argues that sustainable patient-centred care in transplantation depends on integrated organisational systems, professional standards, and institutional accountability rather than the efforts of individual clinicians alone.
The commentary, authored by Dr. Sulkhan Inaishvili, examines how Georgia’s transplant programmes can strengthen their approach to patient care by embedding professionalism, communication protocols, and ethical governance into their organisational structures—a shift that aligns with international accreditation standards and the principles of the World Health Organization’s person-centred care framework.
The complexity of liver transplantation: Why patient-centred care matters
Liver transplantation is not a single clinical event. It represents what Inaishvili’s article describes as “one of the most complex and ethically demanding domains of contemporary healthcare,” characterised by prolonged care pathways, severe organ scarcity, and heightened vulnerability of both recipients and living donors.
In Georgia, where living donor liver transplantation is a significant component of transplant activity, the stakes are particularly high. Both recipient and donor enter a lifelong medical relationship with the transplant centre—requiring continuity of care, transparent communication about risks and outcomes, and robust ethical safeguards. Yet these elements are not guaranteed by individual clinician compassion alone. They require institutional infrastructure.
The analysis draws on international transplant evidence, Georgian clinical experience, and accreditation standards to demonstrate that patient-centred transplant care can only be sustained through integrated systems of professionalism, communication, and institutional accountability. This finding aligns with earlier reporting on early outcomes and blood group matching in Georgian liver transplant programmes, which highlighted both clinical progress and the need for standardised protocols.
Five critical domains for patient-centred transplant systems
Inaishvili’s article identifies five areas where Georgian transplant services must strengthen organisational systems:
- Access and intake: Transparent, equitable criteria for patient selection and fair allocation of scarce organs
- Informed consent: Structured processes to ensure recipients and living donors understand realistic risks, benefits, and long-term commitments
- Living donation ethics: Safeguards to protect donor autonomy, prevent coercion, and ensure donor follow-up and support
- Communication pathways: Standardised protocols for information-sharing across the care team and with patients and families
- Ethics oversight: Institutional ethics committees with transplant-specific expertise and authority to review cases and guide policy
These five domains are not optional extras; they are foundational to sustainable transplant programmes.
“Patient-centred transplant care can only be sustained through integrated systems of professionalism, communication, and institutional accountability.”
— Sulkhan Inaishvili, Georgian Medical Journal, 2025
Professionalism as an organisational responsibility
A key insight from Inaishvili’s analysis is that professionalism in transplant care is not merely an individual virtue—it is an organisational and educational responsibility. This distinction matters because it shifts accountability from individual clinicians to institutions and leadership.
When a patient feels unheard, or a living donor is not properly informed about risks, or a recipient receives conflicting information about follow-up, the problem often lies not with an individual’s character but with the absence of standardised systems. The solution, therefore, is not just to hire more compassionate doctors—it is to build institutional structures that embed patient-centred values into workflows, training, and governance.
Georgia’s transplant centres have the opportunity to lead in this space. The Georgian Medical Journal continues to publish clinical and operational research from Georgian transplant teams, documenting both progress and lessons learned.
Living donor protection: A cornerstone of ethical transplant care
Living donor liver transplantation occupies a special ethical position. Unlike deceased donor transplants, living donation carries real medical risk to a healthy person. International consensus emphasises that donors must be protected through careful screening, informed consent, and long-term follow-up—and that no form of financial incentive should compromise donor autonomy or exploit economic vulnerability.
In Georgia, where blood group compatibility and family relationships shape living donation patterns, institutional ethics oversight becomes essential. Inaishvili’s article argues that transplant programmes must implement structured processes for:
- Independent assessment of donor voluntariness and understanding
- Careful evaluation of psychosocial suitability and ongoing support
- Long-term medical follow-up for donors, including monitoring for late complications
- Documentation and transparency that withstands external review
These are not bureaucratic burdens. They are ethical necessities that protect the most vulnerable participants in the transplant system—and they strengthen public trust in transplant programmes overall.
Key takeaways
- Patient-centred care in liver transplantation must be embedded in organisational systems and institutional accountability, not left to individual clinician effort (Inaishvili, 2025)
- Five critical domains—access, informed consent, living donation ethics, communication, and ethics oversight—require standardised protocols and governance structures (Inaishvili, 2025)
- Georgia’s expanding transplant services have clinical capacity but must now strengthen systemic safeguards for patient communication, continuity of care, and ethical protection of living donors (Inaishvili, 2025)
Frequently asked questions
What does ‘patient-centred care’ mean in transplantation?
Patient-centred care means designing transplant services around the patient’s and family’s needs, values, and preferences—not just clinical outcomes. This includes transparent communication, genuine informed consent, continuity across the care team, and shared decision-making. In transplantation, it also requires protecting the autonomy and safety of living donors.
Why is institutional responsibility more important than individual effort?
Individual clinicians cannot sustain patient-centred care alone. Systems fail when they rely on individuals: staff turnover, inconsistent practice, and gaps in oversight create harm. When patient-centred values are embedded in protocols, training, governance, and accountability structures, they survive staff changes and scale reliably across a whole programme.
What are the main risks for living donors in liver transplantation?
Living liver donors face surgical risks including bleeding, infection, and bile leak. They may also experience chronic pain, fatigue, or reduced quality of life after donation. They carry a small but real mortality risk. Ethical transplant programmes protect donors through independent assessment, thorough informed consent, long-term medical follow-up, and psychological support.
How do accreditation standards support patient-centred transplant care?
International accreditation bodies have developed specific standards for organ donation and transplantation that require programmes to demonstrate transparent access criteria, informed consent processes, living donor protection, ethics oversight, and patient communication. These standards drive institutional improvement and are recognised markers of quality and safety.
What comes next for Georgian transplant services?
Georgia’s transplant community has built clinical expertise and demonstrated growing capacity. According to Inaishvili’s analysis, the next chapter must focus on the systems and safeguards that sustain quality and trust. This means investing in ethics committee infrastructure, standardising patient communication protocols, implementing structured informed consent processes, and ensuring long-term follow-up for both recipients and living donors. It also means training the next generation of transplant professionals to see these systems not as compliance burdens but as expressions of professionalism and care. International accreditation pathways, ongoing publication of Georgian transplant outcomes and practice innovations in the Georgian Medical Journal, and peer learning with regional and global transplant programmes can all support this transition. The expansion of Georgia’s transplant services over the past decade has been a clinical success. The challenge now is to make it sustainable by ensuring that patient-centred care is not a hope or a slogan, but a reality built into the fabric of how transplant programmes operate.
Full citation
Inaishvili S. Patient-centred Care in Liver Transplantation in Georgia: Implications for Professionalism, Communication, and Accredited Transplant Services. Georgian Medical Journal. 2025. doi: 10.5281/zenodo.18207027
Source: Read the full article in the Georgian Medical Journal
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Disclaimer. This article is health journalism intended for general information and education. It is not medical advice and is not a substitute for professional diagnosis or treatment. Always consult a qualified healthcare provider about your individual circumstances. Full disclaimer →
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Medically reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD. Spotted an error? Contact the editorial team.
