Palliative care for patients with end-stage liver disease ineligible for liver transplantation.
The proportion of patients with ESLD who will be managed without liver transplantation will increase in the near future, largely as a result of the increasing age of the population. Patients with ESLD are subject to many physical and psychosocial symptoms that negatively affect health-related quality of life. Sleep quality should be maximized by controlling pruritus and leg cramps. Many frequently used therapies are not supported by a strong evidence base. Advance directives should be addressed with all patients with ESLD, preferably in the outpatient setting before an acute deterioration. Medicare provides a hospice benefit for patients with ESLD, and referral to a hospice is appropriate for patients with an expected survival of 6 months or less.
Sanchez
William
W
Department of Medicine, Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55901, USA.
Talwalkar
Jayant A
JA
D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000628:therapy*; D016031:Liver Transplantation; D010166:Palliative Care; D018579:Patient Selection; D011379:Prognosis