Indications for liver transplantation
Four routes onto a transplant list
- Four routes onto a transplant list:
1. Acute liver failure - hours to days
2. Decompensated cirrhosis - MELD-driven
3. Hepatocellular carcinoma within criteria
4. Quality-of-life / non-MELD indications - intractable pruritus, recurrent cholangitis, hepatopulmonary syndrome, polycystic liver disease, metabolic disease with extrahepatic effects
- *The referral trigger for chronic disease is the first decompensation, not the last* - median survival falls from >12 years to ~2 years at that point
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