What are the key indications for urgent referral to a specialist in cases of suspected acute liver failure?

Key indications for urgent referral to a specialist in suspected acute liver failure include:

• Development of decompensated liver disease symptoms such as ascites, encephalopathy, or gastrointestinal haemorrhage, which require immediate referral to a hepatologist or gastroenterologist with an interest in hepatology.
• Any adult with suspected acute liver failure or decompensated liver disease should be referred immediately for specialist assessment.
• In cases of acute alcohol-related hepatitis severe enough to consider corticosteroid treatment, referral to a specialist experienced in managing alcohol-related liver disease is indicated.
• Patients with chronic hepatitis B who develop signs of liver failure or decompensation should be referred urgently to a hepatologist or specialist in infectious diseases with hepatology expertise.

These referrals are critical to ensure timely specialist management, including consideration for liver transplantation and advanced supportive care.

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