Overview

It's 2 a.m., the patient is bleeding from varices, the INR is climbing, and you have minutes - not hours - to decide whether to correct it, scope it, or call the transplant center. Apply the wrong reflex - reverse the coagulopathy in acute liver failure, miss the King's College window, treat hepatorenal syndrome as prerenal - and the organ that could have regenerated is lost while you were following a rule that did not apply to this patient. This handbook rebuilds the way you reason at the bedside: recognize the pattern, branch the workup, apply the right score, and act inside the window that rarely reopens. Inside this book: - Decode the enzyme pattern - turn an ambiguous LFT set into a working diagnosis before the first specialist call. - Stage before you treat - apply MELD 3.0, Child-Pugh, FIB-4, and BCLC the way allocation committees and tumor boards actually use them. - Master the 3 a.m. decisions - variceal hemorrhage, hepatorenal AKI, and the acute-on-chronic patient, scripted step by step. - Stop correcting the INR in acute liver failure - and know exactly when King's College criteria mean transplant or death. - Read the liver in pregnancy - separate physiological change from AFLP, HELLP, and the bile-acid threshold that predicts stillbirth. - Manage the immunocompromised host - checkpoint inhibitor hepatitis, HBV reactivation, and why infliximab is the wrong rescue. - Carry 30 decision pathways - every chapter distilled into a bedside algorithm, indexed three ways in the Master Compendium. Written for hepatologists, gastroenterologists, internists, hospitalists, intensivists, residents, fellows, and the advanced practice clinicians who manage liver disease on the front line. Open it before your next liver patient - and decide with understanding, not reflex.

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