skip to main content

Liver Transplant for Alcoholic Cirrhosis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateGastroenterologyLiver Transplant for Alcoholic CirrhosisRACP Adult Medicine

A 50-year-old man with alcoholic cirrhosis (Child-Pugh C, MELD 28) has been abstinent from alcohol for 8 months. He has recurrent variceal bleeding, refractory ascites, and hepatic encephalopathy. He has no active infection or malignancy. He has good social support. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Refer for liver transplant assessment

Decompensated alcoholic cirrhosis with MELD >15, despite optimal medical management, is an indication for liver transplant assessment. Most Australian centres require a minimum of 6 months alcohol abstinence (though this is increasingly individualised). The 6-month rule is controversial; early transplant for severe alcoholic hepatitis is being evaluated. Comprehensive psychosocial assessment is essential.

Reference: TSANZ – 2024 – Liver Transplant Guidelines; GESA 2024