Couple fly to Turkey for life-saving liver transplant after NHS denies operation

A woman with a rare type of liver cancer has been forced to travel to Turkey for a life-saving liver transplant after being denied the operation on the NHS.

Flo Moffat-Charles from Kendal in Cumbria, was diagnosed with a rare liver disease called PSC (Primary Sclerosing Cholangitis) in January 2024, after putting her fatigue, itchy skin and nausea down to eczema and a busy work schedule.

The disease, which affects about one in 10,000 people in the UK, also comes with an increased risk of liver and bile duct cancer. Last year, the 31-year-old was diagnosed with Cholangiocarcinoma – a rare and aggressive form of bile duct cancer.

A liver transplant is now potentially the only curative treatment option for Flo, but due to the location of her cancer the NHS deemed a transplant to be too risky and she is unable to have the operation in the UK.

Determined to have the best chance of survival, Flo and her husband Josh Moffat-Charles, 32, decided to seek treatment in Turkey with the possibility of Josh being her living donor. But the operation comes with a hefty £200,000 price tag.

“We’re not willing to just sort of roll over and take what’s available to us here,” Josh told the Independent. “Without a transplant, the only option left here in the UK will be palliative treatment. With a transplant, she could gain everything. More life, more adventures and more time with those who love her. A future,” he said.

“I wish that this was a surgery that I could have in the UK around my family, friends nearby, just being on home ground. It naturally puts your mind at ease, but having gone out to Turkey already and seeing the hospital and meeting the surgeon, I do feel very safe there as well,” Flo added.

There is no cure or treatment for PSC, only medication to manage the symptoms and Flo was told she would eventually need a liver transplant.

While undergoing tests for a transplant in January 2025 at University College Hospital London (UCLH) a specialist discovered cancerous cells in the bile ducts and tumours and diagnosed her with Cholangiocarcinoma – which has a five year survival rate of 6 to 9 per cent.

“Unfortunately from that point, the route we were going down looking at transplant there was suddenly a non-option because we had to deal with the cancer,” Flo said.

Flo spent the next year undergoing chemotherapy, but by May this year despite scans showing no cancer progression, she was still not eligible for a transplant on the NHS.

She explained the NHS has to calculate the benefits and risks of a liver transplant and there is an “apprehension” to give a patient with cancer and PSC a transplant over fears the cancer could spread.

She added that it’s suggested a transplant patient in recovery would struggle to also undergo chemotherapy.

“I could only focus on what was in front of me. I must have been on autopilot, because I probably didn’t take in quite how big this was, and I perhaps still had a blind optimism,” Flo said.

The couple decided to seek treatment abroad and settled on a hospital in Turkey and launched a fundraiser to help fund it.

Josh is a possible live donor for Flo, but there are added complications with his liver that may increase the risks in surgery. The couple is now weighing up their options and considering finding another donor.

The restrictive guidelines around transplants has “been a hurdle” for Flo who suggested there should be “greater flexibility” for certain cancers if the patient is making progress.

“I’ve been responding well to treatment in that it’s keeping me stable and actually right now I feel the strongest and most well that I’ve felt in a long time,” Flo said.

AMMF, a charity that specialises in cholangiocarcinoma explained people with the cancer can have successful transplants in “rigorously selected patients when performed in highly specialised centres.”

“Transplantation surgery for those with PSC who go on to develop cholangiocarcinoma is very new here in the UK and is following a strict eligibility protocol that’s in line with most international guidelines to ensure that evidence can be built around its effectiveness,” Helen Morement, Chief Executive of AMMF – The Cholangiocarcinoma Charity said.

“All of us at AMMF are deeply concerned to learn that Florence and her husband are having to look to Turkey to secure the surgery she needs. Our ‘Rethink Liver Cancer’ campaign is highlighting the need for a network of centres of expertise for cholangiocarcinoma within the NHS to encourage earlier diagnosis of this cancer and improve access to all possible treatments for patients like Florence.”

A UCLH spokesperson said: “We recognise that decisions relating to organ transplantation can be deeply distressing for patients and families.

“Donor organs are extremely limited and all transplant candidates are assessed against nationally agreed clinical criteria. These are designed to ensure that organs are allocated fairly and in the best interests of all patients.

“We will continue to care for Flo and support her through her treatment.”

An NHS Blood and Transplant spokesperson said: “Sadly there are not enough organs from deceased donors in the UK. If someone receives an organ, it means someone else will not receive it. The transplant community works together to try and create fair policies which prioritise people who could benefit.

“Every transplant centre has to ensure that each patient they recommend for transplant can achieve satisfactory outcomes, to make the best use of precious donated organs.

“NHS Blood and Transplant supports the work of hospitals and commissioners on living donation. Living donation can be an increasing source of donor livers and there are new programmes to improve access for people who want to make a directed living liver donation. Doctors will still need to consider each case carefully and decide whether the operations are in the best interests of the donor and the recipient and whether they will achieve satisfactory outcomes.”