Liver Disease

Admission Criteria for End-Stage Liver Disease
Patient must have both:
a. Prothrombin time (PT) more than 5 seconds over control, or International Normalized Ratio (INR) > 1.5
b. Serum albumin < 2.5 gm/dl

Documentation of specific liver disease in history and physical, and the patient shows at least one of the following:
a. Ascites, refractive to treatment, or patient non-compliant
b. Spontaneous bacterial peritonitis
c. Hepatorenal syndrome; elevated creatinine and BUN; oliguria (< 400 ml/day) and urine sodium concentration < 10 mEq/l
d. Hepatic encephalopathy, refractory to treatment, or patient non-compliant
e. Recurrent variceal bleeding, despite intensive therapy

  • Karnofsky score of 60 or less
Supporting Documentation:
a. Progressive malnutrition
b. Muscle wasting with decreasing strength and endurance
c. Continued active alcoholism (.80 gm alcohol/day)
d. Hepatocellular carcinoma
e. HBsAg (Hepatitis B positivity)
f. Hepatitis C refractory to interferon treatment