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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

  • Patients who are hepatitis B surface antigen (HbsAg) positive
  • Pregnant women who are hepatitis B surface antigen (HbsAg) positive
  • Patients who are immunosuppressed or starting immunosuppressant medicines who are hepatitis B surface antigen (HbcAb) positive (e.g. transplant patients, starting chemotherapy).

Information to be included in the referral

Information that must be provided

  • Hepatitis B virus (HBV) serology results
  • Hepatitis C virus and HIV serology
  • Liver function tests
  • Full blood examination
  • Upper abdominal ultrasound results
  • If pregnant, gestational age
  • Current and complete medication history (including non-prescription medicines, herbs and supplements).

Provide if available

  • Previous liver biopsy results
  • Details of previous medical management including the course of treatment and outcome of treatment.

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

  • Patients who are hepatitis B surface antigen (HbsAg), unless they are immunosuppressed or starting immunosuppressant medicines and are hepatitis B surface antigen (HbcAb) positive.