What criteria should I use to determine when to refer a patient with a

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Criteria for referral of a patient with alcoholic liver disease to a specialist include:

Refer people to a specialist experienced in the management of alcohol-related liver disease to confirm a clinical diagnosis when there is a history of harmful or hazardous drinking with abnormal liver blood test results .
Refer people diagnosed with cirrhosis to a hepatology specialist for further management .
Refer patients with decompensated liver disease (e.g., jaundice, ascites, variceal bleeding, hepatic encephalopathy) for specialist assessment ,.
Consider referral for liver biopsy if diagnosis is uncertain or to confirm severe alcohol-related hepatitis when corticosteroid treatment is being considered .
Refer patients with decompensated liver disease who remain so after best management and 3 months’ abstinence from alcohol for assessment for liver transplantation if otherwise suitable .

What criteria should I use to determine when to refer a patient with alcoholic liver disease to a specialist for further evaluation?