Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Dec 20, 2024; 14(4): 95904
Published online Dec 20, 2024. doi: 10.5662/wjm.v14.i4.95904
Palliative care for end-stage liver disease and acute on chronic liver failure: A systematic review
Vakaola I Pulotu Mafi, Jonathan Soldera
Vakaola I Pulotu Mafi, Jonathan Soldera, Post-Graduate Program, Acute Medicine, University of South Wales, Cardiff CF37 1DL, United Kingdom
Author contributions: Mafi VIP, Soldera J participated in the concept and design research, drafted the manuscript and contributed to data acquisition, analysis and interpretation; Soldera J contributed to study supervision; all authors contributed to critical revision of the manuscript for important intellectual content.
Conflict-of-interest statement: The authors affirm that they have no conflicts of interest pertaining to the subject matter discussed in this paper.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jonathan Soldera, MD, MSc, PhD, Instructor, School of Acute Medicine and Gastroenterology, University of South Wales, Llantwit Road, Pontypridd, Cardiff CF37 1DL, United Kingdom. jonathansoldera@gmail.com
Received: April 21, 2024
Revised: June 20, 2024
Accepted: July 3, 2024
Published online: December 20, 2024
Processing time: 95 Days and 11.8 Hours
Core Tip

Core Tip: This systematic review addresses the underexplored utilization of palliative care (PC) in patients with end stage liver disease (ESLD) and acute on chronic liver failure (ACLF), a demographic traditionally underserved. ESLD and ACLF are characterized by grim prognoses, substantial care costs, explicit patient suffering, and elevated mortality rates. Despite liver transplantation (LT) being a curative option, accessibility remains severely limited due to barriers such as donor scarcity, financial constraints, and inadequate social support. Even among those eligible for transplantation, a significant majority of ESLD patients are referred late for PC, typically within their final couple of weeks of life. PC offers notable benefits, including amelioration of symptom burden, reduced depressive symptoms, lower readmission rates, and shorter hospital stays. However, optimal utilization of PC faces barriers such as the allure of transplants and misconceptions about PC. A comprehensive understanding of the pivotal role of PC in ESLD and ACLF treatment is crucial for all stakeholders, including healthcare providers, patients, and caregivers, to overcome these barriers. Future prospective randomized studies, irrespective of LT eligibility, are needed to strengthen the evidence supporting early integration of PC in the management of ESLD/ACLF patients.