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Question category: Gastroenterology

A 46 year old female presents with fatigue, myalgia and pruritus. She is complaining of vague right upper quadrant pain and has noticed her skin and eyes appearing yellow in colour. On examination there is evidence of hepatomegaly and jaundice. Bloods reveal deranged LFTs (predominantly raised aminotransferases), a normocytic anaemia, elevated IgGs and anti nuclear antibodies and anti smooth muscle antibodies. She is commenced on steroids and azathioprine however she continues to deteriorate and now presents with decompensated cirrhosis. What is the next management step?


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