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Gastroenterol Clin North Am. 2006 Mar;35(1):201-19.

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

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Department of Medicine, Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55901, USA.


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.

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