The six-decade career of Roger Williams, who has died at the age of 88 after suffering a heart attack, lay at the heart of an astonishing transformation in liver medicine.
In 1968, while a hepatologist at King’s College hospital in London, he teamed up with the Cambridge surgeon Roy Calne to form the Cambridge-King’s transplant programme and carry out the UK’s first liver transplant.
Williams knew that if your kidneys fail, dialysis can keep you alive, but there is no comparable lifeline if your liver fails. Transplants were the only hope for some of his liver patients and he was determined to make a success of the venture.
In the 1960s and 70s a donor liver was not viable for long. The recipient and the medical team had to travel to the hospital where the donor had died and carry out the transplant there. Dashing at short notice to different hospitals could be detrimental to family life: in 1954 Williams had married his fellow medical student Lindsay Elliott, and they had two sons and three daughters.
Williams led the liver unit at King’s from 1966 to 1996, building it into a world-class centre. In 1971 he built a laboratory on the roof of the liver ward and he had an ethos of continuous research that fed into clinical practice. Refined surgical techniques, immunosuppression drugs and the ability to keep organs viable for longer meant that as the decades passed he could offer liver transplants to more patients.
Williams’ unit also researched diagnosis and treatments for conditions such as cirrhosis, hepatitis, drug poisoning and sepsis, as well as different means of supporting a failing liver, including filtering blood through charcoal. Altogether Williams published over 2,750 papers on every aspect of liver disease and trained over 600 doctors and scientists from around the world, many of whom themselves are now leaders in hepatology.
Sponsorship was key to state of-the-art laboratories, and Williams was very successful at persuading philanthropists to support his work, including Sir Max Aitken and Lord (Arnold) Goodman. Williams and Elliott divorced in 1977, and at Goodman’s office Williams met his second wife, Stephanie de Laszlo, a lawyer. They married in 1978 and had a son and two daughters.
Tall, purposeful and hugely energetic, Williams turned 65 in 1996: when King’s declined to renew his contract, he was not ready to retire. Displaying what one colleague described as “an almost childlike simplicity for seeing what was right and taking what he wanted”, he simply set up a new clinic, the Institute of Hepatology, at University College London, funded by his charity, the Foundation for Liver Research.
Part of a liver can be transplanted from a living donor to help someone in need of a transplant, and there in 1998 he established the first adult-to-adult living donor transplantation programme in the UK. While he was at UCL, as well as continuing to see patients, he developed a support device in 2002, known as MARS (molecular adsorbents recirculating system) which filtered out toxins from the blood. He also researched the causes and treatment of ACLF (acute-on-chronic liver failure) when a patient with cirrhosis suddenly deteriorates.
In 2000 Williams asked a new patient what he did for a living. Paying little attention to sport, he had not recognised the footballer George Best. Williams oversaw Best’s treatment and his transplant, conducted by the surgeon Nigel Heaton, in 2002. He and Best together raised awareness of liver disease, addressing a cross-party group of MPs about alcoholism.
He became very fond of Best and in 2005 had the sad task of telling his family that he had died. His own daughter, Fiona, died suddenly of heart disease and this helped equip him to empathise with grieving relatives.
An administrative attempt to unify Williams’ unit at UCL with the liver unit at the Royal Free Hospital in north London was not a success, and Williams was thrilled to be able to leave. He went back to King’s, and set up a new institute – his third. He arrived in July 2016, in time for a celebration of 50 years of liver disease treatment at King’s.
Williams was horrified when the government ushered in “the absolute lunacy of 24-hour drinking” in 2005, and by the rise of obesity and fatty liver disease. Though politically he was an arch-conservative, chairing the lobby group Conservative Health, he was furious that the UK was failing to deliver on the opportunity he had created for it to improve liver health.
He teamed up with the Lancet and put together a standing commission on liver disease to make evidence-based recommendations. From 2014, he wrote and edited the commission’s annual reports, handing in the last one in June 2020.
Born in Bexleyheath, Kent (now the London borough of Bexley), Roger was an only child, and the family moved to Southampton shortly after his birth. His father, Stanley, was an estate agent and his mother, Doris (nee Clatworthy), ran the sailmaker JR Williams in Hamble. His parents had married in Jos, Nigeria, where Stanley was an engineer, and his mother gave young Williams his first boat, named “Jos of Hamble”. Throughout his life Williams loved racing – never missing Cowes Week – and gave all his subsequent boats the same name.
Williams attended St Mary’s college in Southampton. A bout of diphtheria at the age of 13 inspired his choice of career, and just four years later he began studying medicine at the Royal London hospital, qualifying in 1953. National Service followed at the Queen Alexandra military hospital, next to what is now Tate Britain on the Thames at Millbank, where he came across soldiers with hepatitis. Williams was beginning to think the liver was the most interesting organ in the body, with its hundreds of functions and unique ability to regenerate.
In 1959 he began training with Sheila Sherlock, the doyenne of liver disease, at the Royal Free hospital and after seven years became a consultant at King’s College hospital. Thereafter he would maintain a friendly rivalry between King’s and the Royal Free.
In 1993 Williams was appointed CBE. At his 80th party, he said the “the thing I’ve lived all my life for is … work”. It was not entirely a joke – even his honeymoon coincided with a hepatology conference in Jerusalem. But he also made time for opera, sailing, tennis and latterly a farm he acquired near Salisbury.
He is survived by Stephanie, seven children and 13 grandchildren.
• Roger Stanley Williams, hepatologist, born 28 August 1931; died 26 July 2020