This guideline is for all healthcare professionals involved in the care of patients with end stage liver disease of any aetiology. This guideline is not intended to be a substitute for specialist expertise and should be used in conjunction with careful individual patient assessment. This guideline is intended for use in patients with advanced liver disease who have limited life expectancy, including those in whom active treatment continues (including referral to a liver transplant unit, and placement on the waiting list) but have a high symptom burden, as well as those patients who may be approaching the last days of life.