Other liver treatment options

If a liver transplant is too risky, there are other options

Key points

Not all patients with end-stage liver disease are suitable for liver transplantation
Due to the risks involved, a liver transplant is only an option for carefully selected patients
Treatments to control your symptoms may be your best option
Talk to your liver doctor about the right treatment for you

Reasons why you might not be able to have a liver transplant

Common reasons why a liver transplant may not be the right treatment for you include:

You are too ill or frail to cope with the surgery and aftercare
Your liver disease may be too advanced to consider liver transplantation
You have recently had cancer, a serious infection, a heart attack or a stroke
You may struggle taking the immunosuppressant medicine after a liver transplant
It is too early for a transplant and it may be better to monitor you closely and reconsider if your condition changes

Other treatment options

Sometimes it’s better or safer to have other treatments. These include:

Improving and tailoring medical treatments and medications
A transjugular intrahepatic porto-systemic shunt (TIPSS) - this is a tube that lets blood bypass the liver so it can be carried around the body
Continuing to avoid alcohol (if your liver disease is alcohol-related)
Nutritional support or exercise programs

Continual care

If you are not having a transplant, you will continue to have follow-up and medical care in your referring centre.

If a transplant is not an option in the future, it may be helpful to have discussions with your referring team about supportive treatments. These focus on managing symptoms and planning for the future, if your health were to deteriorate.

Planning for the future

Even if you are listed for a liver transplant, it is often useful to have conversations regarding your plans for the future. These plans should consider your options if your health were to deteriorate and a liver transplant was not available.

This is a concept known as ‘parallel planning’ - hoping for the best (liver transplantation or alternative treatment) but preparing and planning for the worst (not being suitable for liver transplantation or being taken off the waiting list).