AASLD AST practice guidelines for liver transplantation candidate evaluation

Guidelines from the American Association for the Study of Liver Diseases (AASLD) and the American Society of Transplantation (AST) for the evaluation of liver transplantation candidates were published in Hepatology by Dove et al. The guidelines were developed by a multidisciplinary writing group, aiming to provide an outline for assessing patients for liver transplantation. 

Key insights: Patients with chronic liver disease who experience a decompensating event or have acute-on-chronic liver failure (ACLF), acute liver failure (ALF), hepatocellular carcinoma (HCC), or cholangiocarcinoma (CCA) should be referred to a liver transplant (LT) center for evaluation conducted by a multidisciplinary team, provided they meet criteria. Patients with non-hepatic malignancies with liver involvement may also be considered for evaluation. Cardiac, pulmonary, physical function, infection risk, and psychosocial evaluation should take place as part of the LT center assessment to assess risk for complications and to identify areas for intervention. Cancer screening and consideration of contraindications are also recommended.  

Key learning: Patients referred to LT centers should be carefully evaluated to determine their eligibility for liver transplantation, taking into consideration individual risks.