When to Consider Liver Transplant During the Management of Chronic Liver Disease

With rising rates of end-stage liver disease and hepatocellular carcinoma, there is a growing demand for liver transplantation. The decision to allocate a liver to a patient is an extensive process in a transplant center, but the timing of initial referral for transplant evaluation will commonly be the responsibility of the primary care physician. This article discusses the indications and contraindications for liver transplantation. The criteria to determine timing of transplant referral are reviewed, and integration of these criteria into long-term management of patients with cirrhosis is emphasized.