In patients with hepatic encephalopathy (HE) whose condition fails to respond to — or cannot be maintained on — available therapeutic options, the clinical pathway leads to a specific definitive intervention. This page describes that scenario and the direction of care involved.
This protocol addresses hepatic encephalopathy in the subset of patients for whom the condition is not controlled by other available treatments. The indication reflects a level of severity and refractoriness that requires escalation to a definitive approach.
The protocol involves an organ-level surgical intervention considered in carefully selected patients. Specific eligibility criteria, contraindications, the decision pathway, and the full structured algorithm are available in the complete evidence-based regimen — accessible via the link below.
DOI: 10.1002/hep.27210
Recurrent intractable overt hepatic encephalopathy (OHE), together with liver failure, is an indication for liver transplant (LT) (GRADE I).
Liver transplantation remains the only treatment option for HE that does not improve on any other treatment, but is not without its risks.
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