Drugs metabolized in the liver must be given with caution. Coagulation disorders will sometimes respond to vitamin K. Liver transplantation is highly effective for the treatment of end-stage cirrhosis. Transplantation is usually needed when complications such as encephalopathy, ascites or bleeding varices are uncontrollable or when biochemical function is severely depressed. In patients with primary biliary cirrhosis, a rising bilirubin indicates a poor prognosis and such patients should be considered for transplantation as the serum bilirubin concentration begins to rise. Active drug or alcohol abuse are contraindications to liver transplantation.
Liver cancer is usually a contraindication to transplantation, except in experimental protocols.
Liver transplantation is usually not performed in patients more than 70 years old.