Meeting the Palliative Care Needs of Hospitalized Patients with End-Stage Liver Disease

End-stage liver disease (ESLD) is a serious illness marked by significant morbidity and mortality, with a median survival of two years without liver transplantation. Many people first learn of their diagnosis during an acute index hospitalization for debilitating complications of liver failure, such as jaundice, ascites, hepatic encephalopathy, and variceal hemorrhage. Patients who survive this hospitalization are vulnerable—they often have limited prognostic understanding and face social stigma due to their liver disease. It is rare that they experience the engagement of palliative care.

In this clinical presentation, transplant hepatologist, Nneka Ufere, MD, MSCE, and palliative care clinician, Nancy Mason, CNP, will provide an overview of LiverPal, a grant-funded pilot program using a multidimensional approach to the delivery of specialty palliative care to hospitalized patients with ESLD, and their caregivers. During this session, the presenters will share approaches to addressing the unique palliative care needs of this patient population across six domains: (1) serious illness communication, (2) illness and prognostic understanding, (3) symptom management, (4) coping with ESLD, (5) coordination of care including transitions of care, and (6) caregiver support.