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What is Palliative and End-of-Life Care

Liver Disease

Who is it for?

The liver is a large organ in the abdomen. It helps the body to do many things such as:

  • digest nutrients
  • clean the blood
  • help the blood to clot
  • process (or metabolize) medications

What causes liver disease?

Cirrhosis is a common liver disease. Healthy liver tissue is replaced with scar tissue, which stops the liver from working the way it should. Some causes of cirrhosis are:

  • heavy alcohol use over years​
  • hepatitis C
  • autoimmune disease (e.g., sclerosing cholangitis)
  • blocked bile ducts (primary biliary cirrhosis)
  • genetic disease (e.g., hemochromatosis, alpha-1 antitrypsin syndrome)

What are the symptoms of liver disease?

People can live for years with cirrhosis as the liver slowly stops working. Body symptoms can include:

  • bleeding in the stomach
  • feeling itchy
  • fluid build-up and swelling in the abdomen (ascites) and legs (edema)
  • loss of appetite
  • nausea
  • pain
  • problems thinking and understanding
  • yellow skin
  • confusion from liver toxins (encephalopathy)

There are also mental health symptoms, such as feeling:

  • anxious
  • unhappy or moody
  • stress from dealing with the diagnosis

How can palliative and end-of-life care help people with liver disease?

People with liver disease often need to be admitted to the hospital because of these problems. While people are getting treatment, palliative care can help to:

  • manage symptoms
  • give emotional support
  • answer questions and concerns about the future
  • find other supports if people need to transition (e.g., go from home to hospital) for care

What about liver transplants?

A liver transplant is surgery where a healthy donor liver or portion of a liver is put into an ill person’s body. It may be an option for some people with liver disease. These people are cared for by the transplant team, a liver specialist, and family doctor.

How can palliative and end-of-life care help people waiting for a liver transplant?

For people on a transplant list, palliative and end-of-life care can:

  • answer questions about symptoms and the future
  • work with transplant teams to manage symptoms while waiting for the liver transplant (e.g., medicine, massage, acupuncture, mindfulness, psychological and spiritual supports)
  • give emotional support and help manage symptoms before and after transplant

Not everyone on a transplant list will have the surgery. For these people and their families, palliative and end-of-life care will:

  • help them have a better quality of life
  • give emotional support, and comfort
  • manage symptoms, including decreased appetite and poor sleep
  • find other supports if people need to transition (e.g., go from home to hospital) for care​