For cirrhotic patients that we take care of in the community, when should be the optimal timing of referral for liver transplantation aside from the MELD score?

This is a challenging issue for all doctors, both as the referring doctor and the transplant institution. We do not want to evaluate patients who are unlikely to be transplanted, but the MELD score is not an adequate reflection of all patients' disease severity. For our referring doctors, I never ha...

Transplant Hepatologist here. I second that we are always happy to see patients with cirrhosis or advanced fibrosis at any time. For considering the time to consider transplant, specifically, we consider complications of cirrhosis that have become difficult to control medically (ascites, HE, recurre...

Refer if they are likely to live longer with a new liver than with their current one. One-year survival after liver transplantation is approximately 90%, so an expected survival lower than that is reasonable. Good examples include a Model for End-stage Liver Disease (MELD) score greater than 15, dec...