Browse topics

Indications for liver transplantation

When to refer for liver transplant (MELD 15, first decompensation, HCC, acute liver failure), calculating and reading MELD-Na, disease-specific indications from PSC to hepatopulmonary syndrome, UCSF and Metroticket 2.0 for HCC in Australia and New Zealand, contraindications, alcohol and the 6-month rule, and the ANZ transplant system.

Tier 2Medical sciences concept

Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made

3 questions 9 flashcards

At a glance

Liver transplant offers about 90% one-year and 75 to 80% five-year survival. The question is when a patient's risk of dying without it exceeds the risk of the operation.
Refer with MELD 15 or more, at the first decompensation, with HCC possibly within criteria, or with acute liver failure (see Acute liver failure).
In Australia and New Zealand, TSANZ guidelines require an expected 5-year survival of at least 50% after transplant. Units allocate deceased donor livers by clinical urgency informed by MELD.

Loading the rest of the note…

Finished reading?

Test yourself on it:3 questions 9 flashcards

Sources

Clinical Guidelines for Organ Transplantation from Deceased DonorsAU/NZTransplantation Society of Australia and New Zealand (TSANZ), Version 1.18, October 2026 (chapter 6, liver)
Expansion of liver transplantation criteria for hepatocellular carcinoma from Milan to UCSF in Australia and New Zealand and justification for Metroticket 2.0. Cancers 2022;14:2777AU/NZCancers (MDPI), 2022
Ethical guidelines for organ transplantation from deceased donorsAU/NZNational Health and Medical Research Council, 2016
Mazzaferro V et al. Metroticket 2.0 model for analysis of competing risks of death after liver transplantation for hepatocellular carcinoma. Gastroenterology 2018;154:128-39Gastroenterology, 2018
Martin P et al. Evaluation for liver transplantation in adults: 2013 practice guideline by AASLD and the American Society of Transplantation. Hepatology 2014;59:1144-65AASLD, 2013 (current AASLD evaluation guideline)
EASL Clinical Practice Guidelines on liver transplantation. J Hepatol 2024;81:1040-1086European Association for the Study of the Liver, 2024

Last updated: 14 November 2026

What changed

14 November 2026 Turnstile bot check on sign-in and signed-out feedback