Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 47: My Patient With Cirrhosis Suffers From Severe Fatigue But Has Normal Liver Function And Has Never Had A Major Complication Of Cirrhosis. Should I Refer This Patient For A Liver Transplant? (continued)

Amrita Sethi, MD; R. Todd Stravitz, MD

No. In the absence of complications of cirrhosis, fatigue in a cirrhotic patient is not an indication for referral for liver transplant evaluation. One of the most important decisions facing a physician caring for a patient with cirrhosis is when to refer for consideration of liver transplantation. In general, patients with normal liver chemistries and without major complications of cirrhosis do not require referral because they have an excellent short-term prognosis. However, they should be under the care of a physician with training in liver disease, for inexperience may lead to a late…