Chronic liver disease results in more than 1 million physician visits and more than 300 000 hospitalizations per year in the United States.
More than 27 000 patients annually progress to end-stage liver disease, liver failure, or death.
Patients with end-stage liver disease experience such complications as encephalopathy, and malnutrition.
Muscle wasting, ascites, esophagogastric variceal hemorrhage, spontaneous bacterial peritonitis, fatigue, and depression also occur.
Despite significant improvements in palliation, patients' quality of life diminishes and their disease will often inexorably progress.
Liver transplantation, a valid treatment option, increases life and reduces many symptoms.
|10% to 15% die without receiving an organ for a potentially treatable illness|
|Journal of the American Medical Association|
Dr Anne Larson and colleagues from Seattle discuss the case of a 55-year-old woman with a life-long history of Hepatitis B awaiting transplant.
The research team explores the transplant eligibility process, and the struggle with maintaining hope for a cure in the face a life-threatening illness.
With the current shortage of organs, up to 10% to 15% of these patients die without receiving an organ.
The team note that many patients are not candidates for transplantation due to comorbid illness.
In addition, the team observed that some patients receive a transplant but succumb to complications of the transplant itself.
Such patients and families face the conundrum of a potentially treatable yet often fatal illness.
Dr Larson's team comments, “In all of these circumstances, the health care team must combine elements of palliative care with life-sustaining therapy to maximize the patient's quality and quantity of life.”