Supportive care in end-stage liver disease: a clinical review

This clinical review aims to describe the complexity of care planning for patients with end-stage liver disease (ESLD). There is no definition of ESLD and no guidelines for the supportive care of patients. A few screening tools can be used to assess ESLD and the prognosis. Complications include hepatic encephalopathy, ascites, malnutrition, gastrointestinal bleeding, pruritus, infections and muscle cramps. Several complications to liver disease might be treated in a different way when the patients are at this stage. Focus shifts from symptom control to palliative care and optimising the patients' quality of life. When limiting alcohol intake, clinicians and patients need to balance its impacts on quality of life. This review addresses how these changes can be carried out by the liver nurses as a part of the liver multidisciplinary team (MDT).