Korean J Hosp Palliat Care.  2017 Sep;20(3):167-172. 10.14475/kjhpc.2017.20.3.167.

Hospice and Palliative Care in End Stage Liver Disease

Affiliations
  • 1Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. drkimmy@yonsei.ac.kr

Abstract

End-stage liver disease (ESLD) is a terminal condition of cirrhosis which cannot be treated without liver transplantation. Thus, it is natural for patients to consider hospice/palliative care (HPC). Since the recent legislation of the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life (Act No. 14013) in Korea, the practicality of this law has become an issue. The criteria for HPC should be defined with consideration to how the severity of each ESLD complication may vary by individual patients. Generally, patients qualify if they have an intractable condition despite aggressive treatment such as the hepatorenal syndrome, hepatic encephalopathy or variceal hemorrhage. However, the option of liver transplantation should be sufficiently discussed with patients and their families before making a decision on HPC. The evaluation of which ESLD patients should receive HPC should be based on a long-term doctor-patient relationship and sufficient objective data. Therefore, a multidisciplinary approach and mutual consultation among cirrhosis specialists and doctors with other expertise are essential to offer optimal and balanced treatments between liver-specific treatment and HPC. Discussed in this review are adequate criteria for HPC and special considerations for ESLD at the point of HPC.

Keyword

End Stage Liver Disease; Hospice care; Palliative care; Transplantation

MeSH Terms

End Stage Liver Disease*
Fibrosis
Hemorrhage
Hepatic Encephalopathy
Hepatorenal Syndrome
Hospice Care
Hospices*
Humans
Jurisprudence
Korea
Liver Diseases
Liver Transplantation
Palliative Care*
Specialization
Transplantation
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