Top 7 Liver and Hepatology Centers in Italy for Decompensated Cirrhosis

TL;DR

• Decompensated cirrhosis can involve ascites, hepatic encephalopathy, portal-hypertensive bleeding and other serious complications that often require coordinated specialist care.
• The seven centers below were selected for their dedicated hepatology, advanced liver disease and/or liver transplant services. They are not ranked from best to worst.
• Important capabilities to look for include hepatology, transplant assessment, emergency endoscopy, interventional radiology, TIPS, intensive care, nutrition and management of complications.
• Italy has a highly active transplant network. Final 2025 data from the Centro Nazionale Trapianti reported 1,753 liver transplants nationwide.
• mama health can help you organize questions, keep your health information together, reflect on changes over time and prepare reports to bring to appointments.

What makes a liver center suitable for decompensated cirrhosis?

A suitable center combines specialist hepatology with access to the services needed when cirrhosis becomes complex.

Decompensation usually refers to complications such as ascites, overt hepatic encephalopathy or variceal bleeding. Baveno guidance also emphasizes that further episodes of decompensation carry additional risk and that liver transplantation should be considered in appropriate circumstances.

For that reason, useful capabilities can include:

• a dedicated hepatology or liver unit;
• experience with ascites and portal hypertension;
• endoscopy for gastro-esophageal varices;
• interventional radiology and TIPS;
• management of hepatic encephalopathy;
• specialist input for kidney problems, infections and nutrition;
• intensive care for acute deterioration;
• liver transplant assessment and follow-up.

AASLD guidance similarly identifies ascites, hepatic encephalopathy and portal-hypertensive gastrointestinal bleeding as major features of hepatic decompensation and recommends consideration of liver-transplant evaluation when clinically significant ascites and related complications occur.

The right center still depends on the individual situation, location, referral pathway, urgency and whether transplant evaluation is relevant.

Which are 7 leading liver and hepatology centers in Italy for decompensated cirrhosis?

The following seven hospitals have established programs relevant to advanced liver disease and transplantation. The order does not represent a medical ranking.

1. AOU Città della Salute e della Scienza di Torino – Molinette, Turin

Why consider it? Turin has one of Italy's largest transplant programs and extensive experience in liver transplantation.

The Centro Nazionale Trapianti reported that Città della Salute e della Scienza di Torino performed the highest number of liver transplants in Italy in 2025, with 194 procedures.

Its liver transplant service includes pre-transplant assessment, coordination of the transplant pathway and post-transplant follow-up. The hospital also manages complex liver disease in adults and provides multidisciplinary transplant services.

The center may therefore be particularly relevant when advanced cirrhosis has reached a point where transplant assessment is being discussed.

Location: Turin, Piedmont

Relevant strengths:

• high-volume liver transplant program;
• pre-transplant assessment;
• adult liver transplantation;
• multidisciplinary transplant expertise;
• long-term follow-up.

2. Azienda Ospedale–Università Padova, Padua

Why consider it? Padua combines advanced hepatobiliary surgery, hepatology and a major liver transplantation program.

Its UOC Chirurgia Generale 2 is specifically focused on hepatobiliopancreatic surgery and liver transplantation. Its transplant activity includes deceased-donor, living-donor, split and pediatric liver transplantation.

Padua also has a dedicated unit caring for people with acute and chronic liver disease during transplant assessment, while on the waiting list and after transplantation.

The program remains highly active. In April 2026, the hospital reported performing 20 liver transplants in a single month.

Location: Padua, Veneto

Relevant strengths:

• liver transplant assessment;
• deceased- and living-donor transplantation;
• split-liver transplantation;
• advanced hepatobiliary surgery;
• coordinated pre- and post-transplant care.

3. IRCCS Policlinico Sant’Orsola, Bologna

Why consider it? Sant’Orsola has services specifically dedicated to cirrhosis, liver failure and transplantation.

Its outpatient service for cirrhosis, liver failure and liver transplantation accepts people with cirrhosis at any stage and from different causes, including those who may or may not be candidates for transplantation.

The hospital's hepatobiliary and transplant surgery service states that its work includes acute and chronic liver disease in the decompensated stage when liver transplantation is required.

Sant’Orsola also provides dedicated assessment for potential transplant candidates and specialist follow-up before and after transplantation.

Location: Bologna, Emilia-Romagna

Relevant strengths:

• dedicated cirrhosis and liver-failure clinic;
• liver transplant assessment;
• hepatology and transplant surgery in the same hospital;
• multidisciplinary follow-up;
• experience with decompensated chronic liver disease.

4. ASST Grande Ospedale Metropolitano Niguarda, Milan

Why consider it? Niguarda combines a dedicated liver unit with hepatology, portal-hypertension expertise and liver transplantation.

Its Hepatology and Gastroenterology service manages cirrhosis, portal-hypertension complications and those awaiting or recovering from liver transplantation. It also has a liver unit for urgent care.

A particularly relevant capability for complex cirrhosis is its work in portal hemodynamics, including hepatic venous pressure gradient measurements. The hospital also has a dedicated liver and kidney transplant surgery service.

These services make Niguarda an important option when portal hypertension, transplant assessment or repeated complications are central concerns.

Location: Milan, Lombardy

Relevant strengths:

• dedicated liver unit;
• cirrhosis and portal-hypertension care;
• liver transplant program;
• HVPG assessment;
• urgent hepatology services.

5. ASST Papa Giovanni XXIII, Bergamo

Why consider it? Papa Giovanni XXIII has a highly specialized hepatology and transplant service with capabilities directly relevant to decompensated cirrhosis.

Its Gastroenterology 1 – Hepatology and Transplantology department manages chronic and acute liver failure, ascites, gastrointestinal bleeding, hepatic encephalopathy and people being evaluated for liver transplantation.

The service also performs paracentesis, portal-pressure measurement and TIPS, a procedure that may be considered in selected situations involving complications of portal hypertension.

The department lists nutrition support for sarcopenia among its specialist services and identifies liver transplantation and acute and chronic liver failure as core areas of expertise.

Location: Bergamo, Lombardy

Relevant strengths:

• management of ascites and hepatic encephalopathy;
• portal-hypertension expertise;
• TIPS;
• transplant assessment and follow-up;
• nutritional support in advanced liver disease.

6. Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome

Why consider it? Gemelli has a structured pathway specifically for liver failure alongside dedicated liver transplant medicine and surgery.

Its clinical pathway for liver failure includes multidisciplinary input from hepatology, emergency medicine, intensive care, endoscopy, interventional radiology and transplant surgery. The pathway addresses complications including ascites, gastrointestinal bleeding and hepatic encephalopathy.

For severe or urgent presentations, the pathway includes emergency management and consideration of whether urgent liver-transplant assessment is appropriate. Less acute complications can be managed through hepatology, gastroenterology or internal-medicine services.

Gemelli also has a dedicated Liver Transplant Medicine unit responsible for assessment before waiting-list entry, care while on the transplant list and medical management after transplantation.

Location: Rome, Lazio

Relevant strengths:

• structured liver-failure pathway;
• emergency management of major complications;
• hepatology and gastroenterology;
• interventional radiology and endoscopy;
• dedicated liver-transplant medicine and surgery.

7. IRCCS ISMETT-UPMC, Palermo

Why consider it? ISMETT is a dedicated high-specialty transplant institute with hepatology services integrated directly into its liver transplant program.

Its Hepatology and Gastroenterology service focuses on assessment and waiting-list evaluation for liver transplantation, post-transplant follow-up and advanced procedures for portal hypertension, including TIPS and variceal embolization.

ISMETT reported 1,872 liver transplants between the start of its program in 1999 and the end of 2025. It provides deceased-donor, living-donor and pediatric liver transplantation.

This combination can be relevant when advanced cirrhosis requires both hepatology expertise and access to a comprehensive transplant pathway.

Location: Palermo, Sicily

Relevant strengths:

• specialist hepatology;
• portal-hypertension procedures including TIPS;
• liver transplant evaluation;
• deceased- and living-donor transplant programs;
• integrated high-complexity care.

How do the seven liver centers compare?

CenterCityLiver transplant programCirrhosis / advanced liver servicePortal hypertension / TIPSCittà della Salute – MolinetteTurinYesYesSpecialist services availableAzienda Ospedale–Università PadovaPaduaYesYesSpecialist services availablePoliclinico Sant’OrsolaBolognaYesDedicated cirrhosis/liver-failure clinicYesNiguardaMilanYesDedicated liver unitYes, including HVPGPapa Giovanni XXIIIBergamoYesYesYes, including TIPSPoliclinico GemelliRomeYesStructured liver-failure pathwayInterventional services availableISMETT-UPMCPalermoYesYesYes, including TIPS

Service availability and referral procedures can change. Confirm current pathways directly with the center or the clinician coordinating your care.

What should you look for when choosing a hepatology center?

Look for expertise that matches the complications and questions you are dealing with rather than choosing a hospital solely because of its reputation.

Useful questions can include:

• Does the center have a dedicated hepatologist experienced in advanced cirrhosis?
• Is there a specific pathway for ascites, hepatic encephalopathy or portal hypertension?
• Is urgent endoscopy available for gastrointestinal bleeding?
• Does the hospital offer interventional radiology and TIPS?
• Can nephrology, infectious-disease and nutrition specialists become involved when needed?
• Is liver-transplant assessment available at the same center?
• How are appointments coordinated after a hospital admission?
• What records and recent test results should be brought to the first visit?
• Can a family member or caregiver be involved in discussions when confusion or memory problems are a concern?

The answers can help you compare centers around the practical needs of your own situation.

What concerns often matter most when living with decompensated cirrhosis?

Practical organization can become almost as important as knowing the medical terminology.

Experiences reflected in mama health's decompensated-cirrhosis resources repeatedly center on keeping track of changes such as abdominal swelling, weight, confusion, bowel habits, medicines and recent test results. Preparing a current medication list and having important questions ready for an appointment can also make a complicated care journey easier to discuss.

Other recurring concerns include uncertainty about what a new symptom means, adjusting daily activity when energy changes, understanding what test results are for and knowing when transplant assessment may enter the conversation.

These experiences also explain why a specialist center is more than a name on a list. Access to coordinated hepatology, endoscopy, radiology, nutrition, intensive care and transplant expertise can matter when several parts of the condition need to be discussed together.

How can mama health help you prepare for specialist liver care?

mama health is a free app for everything your condition asks of you, grounded in medical science and the experience of others, so you don't have to figure it out alone.

You can use mama health to:

• Ask anything. Answers are shaped by trusted sources, your history and thousands like you.
• Find specialists and care near you, wherever you are.
• Understand your labs, prescriptions and reports, read against your history in clear educational language.
• Track and reflect on your health journey, including information you may want to remember between appointments.
• Turn what you have recorded into structured reports that you can take to a doctor's appointment.
• Keep questions, recent results and medication information in one place before a specialist visit.

This can be especially useful when several appointments, prescriptions, investigations or hospital reports have accumulated over time.

mama health does not determine whether a hospital, procedure or transplant is appropriate for you. Those decisions belong with qualified healthcare professionals.

Which mama health guides can you read next?

For a broader introduction, read decompensated cirrhosis.

For an explanation of the condition and its major complications, see what happens when cirrhosis becomes decompensated.

If you are trying to understand how advanced liver disease can change over time, read how the stages of cirrhosis relate to the care journey.

For questions about prognosis and what can influence it, see understanding life expectancy with advanced cirrhosis.

When should urgent medical care be considered?

Certain changes associated with decompensated cirrhosis can require prompt medical assessment.

Examples include vomiting blood, black or bloody stools, sudden or marked confusion, severe drowsiness, rapidly worsening abdominal swelling, fever with significant deterioration, fainting or breathing difficulty. Major bleeding, hepatic encephalopathy and complicated ascites can require urgent hospital care.

If severe or rapidly worsening symptoms are happening now, emergency medical services or the existing clinical team are more appropriate than an online information tool.

What is the bottom line?

Italy has several highly specialized hepatology and liver-transplant centers capable of managing complex advanced liver disease.

Turin, Padua, Bologna, Milan, Bergamo, Rome and Palermo all have major services relevant to decompensated cirrhosis. The most suitable option depends on the complications involved, geographic access, existing referrals and whether specialist procedures or transplant assessment may be relevant.

Rather than looking for a single universally “best” hospital, it can be more useful to compare the expertise available with the questions that need answering in your own care.

Disclaimer: This content is informational and not a medical device. mama health offers information and support and does not replace a doctor.