End-Stage Liver Disease: Challenges and Practice Implications

Lissi Hansen, Anna Sasaki, Betsy Zucker

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations


As the seventh leading cause of death among people aged 25 to 64 years, end-stage liver disease (ESLD) affects many Americans in the most productive years of their lives. Despite the increasing number of individuals who are dying of ESLD, little is documented about their end of life challenges as the disease progresses. The purpose of this article is to highlight specific challenges for people with ESLD, their families, and their implications for health care providers: ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, malnutrition, altered drug metabolism, renal insufficiency and hyponatremia, hepatocellular carcinoma, and pain. The authors also present a case study to illustrate disease progression and difficulties facing patients, family members, and providers.

Original languageEnglish (US)
Pages (from-to)411-426
Number of pages16
JournalNursing Clinics of North America
Issue number3
StatePublished - Sep 2010


  • End of life
  • End-stage liver disease
  • Pain
  • Palliative care

ASJC Scopus subject areas

  • General Nursing


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