Current Hepatology Reports

, Volume 17, Issue 1, pp 70–77 | Cite as

Early Integration of Advance Care Planning (ACP) into Cirrhosis Care: Why We Need It

  • Amanda Brisebois
  • Puneeta Tandon
Management of Cirrhotic Patient (A Cardenas and P Tandon, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Management of the Cirrhotic Patient


Purpose of Review

Patients with cirrhosis are largely unaware of the disease trajectory. This review emphasizes the importance of early advance care planning (ACP) and provides practitioners with a framework to apply these concepts.

Recent Findings

Literature is arising describing the importance of ACP and application of palliative principles (symptom management, quality of life, social, spiritual, and emotional care) in cirrhosis care. Understanding illness trajectories can promote symptom control, promote appropriate location of care, and ease care transitions. Our group of practitioners has spent time reviewing literature on ACP and has published tools to educate patients, surrogates, and health practitioners regarding the importance of these principles. In addition, work is ongoing to integrate this very important aspect of care into the daily practice of practitioners who managed end-stage-liver disease.


Early ACP and integration of palliative principles into cirrhosis care is critical. Provided is an action plan for implementing early ACP into end-stage liver disease (ESLD) care.


Advance care planning Cirrhosis End-stage-liver disease Palliative care Personal directives 


Compliance with Ethical Standards

Conflict of Interest

Amanda Brisebois and Puneeta Tandon each declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Medicine, Division of Internal Medicine, 2D4.48, WCM CenterUniversity of AlbertaEdmontonCanada
  2. 2.Department of Oncology, Division of Palliative CareUniversity of Alberta and Covenant HealthEdmontonCanada
  3. 3.Cirrhosis Care Clinic, Department of Medicine, Division of GastroenterologyUniversity of AlbertaEdmontonCanada

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