Palliative care for patients with end-stage liver disease ineligible for liver transplantation

Gastroenterol Clin North Am. 2006 Mar;35(1):201-19. doi: 10.1016/j.gtc.2005.12.007.


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.

Publication types

  • Review

MeSH terms

  • Humans
  • Liver Diseases / complications
  • Liver Diseases / therapy*
  • Liver Transplantation
  • Palliative Care*
  • Patient Selection
  • Prognosis