No abstract

CME Liver diseaseLiver transplantation provides effective therapy for most forms of acute and chronic liver failure -one-year survival rates exceed 90% 1 -and the indications continue to expand. In general terms, the indications for liver transplantation are objective evidence of liver failure and subjective criteria such as poor quality of life due to liver disease and occasionally rare metabolic defects. Chronic liver diseaseIn chronic liver disease the most important aspect of patient selection is timing. Transplantation should improve both quality and quantity of life. The procedure is optimally carried out when the patient is well enough to withstand the procedure, but ill enough to warrant it (ie predicted survival is about 1-2 years without a transplant). Assessment for transplantation in chronic liver disease is difficult. Objective and subjective measures are used. The Child-Pugh classification 2 (Table 1) allows objective assessment of a patient's functional liver status and in the USA forms the basis for the criteria required to list patients. Those with Childs C grade have a 58%, 21% and 0% one-year, five-year and 10-year survival, respectively.Subjective measures of liver disease may be more difficult to assess. Tools are available to document quality of life 3 , and a full psychosocial assessment should be carried out. Cholestatic liver disease Primary biliary cirrhosis

No abstract

No abstract

No abstract