Direct to an emergency department for:

  • Acute liver failure
  • Sepsis in a patient with cirrhosis
  • Severe hepatic encephalopathy
  • Severe ascites restricting movement and breathing.

Criteria for referral to public hospital specialist clinic services

  • Suspected cirrhosis suggested by one or more of the following:
    • evidence of cirrhosis on imaging
    • platelet count < 120 x 109 per litre
    • ascites
    • hepatic encephalopathy
    • AST to platelet ratio index (APRI) > 2.0.

Information to be included in the referral

Information that must be provided

  • History of alcohol intake
  • History of injectable drug use
  • Current and historical liver function tests
  • Full blood examination
  • International normalised ration (INR) result
  • Urea and electrolytes
  • Upper abdominal ultrasound results
  • Hepatitis B virus and Hepatitis C virus serology results
  • History of diabetes
  • Iron studies
  • Current and complete medication history (including non-prescription medicines, herbs and supplements).

Provide if available

  • Height, weight and body mass index.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

Not applicable.