According to Pugh's classification moderate to severe hepatic insufficiency is managed by -

Child-Pugh' s classification is used to assess the status of pt. of liver cirrhosis. A liver cirrhotic pt. having variceal bleeding or ascites can be controlled by shunt surgery only if he falls in Child-Pugh's 'A' class (or some pts. of B class). Moderate to severe grade liver insufficiency can only be managed by liver transplantation. Ref : CMDT, 2001, p 682