Palliative Care in Liver Transplantation

Abstract Purpose of Review Although there has been increasing recognition for the importance of palliative care in chronic liver disease, symptom management in liver disease is not very well studied. We reviewed the literature for the most common symptoms associated with chronic liver disease and summarize the latest evidence-based treatments for symptom management. Recent Findings We discuss strategies to manage pain, ascites, hepatic encephalopathy, pruritis, muscle cramps, sexual dysfunction, depression, anxiety, insomnia, and malnutrition. These symptoms are best addressed with a multi-modal approach with non-pharmacologic therapies as an adjunct. Summary Palliative care is an underutilized resource due to the misconception that being a liver transplant candidate precludes patients from accessing these services. However, early integration of palliative care has become increasingly important for both pre- and post-liver transplant patients as it not only improves patient outcomes, but also promotes quality of life that extends beyond graft or patient survival.