A 43-year-old man presents with jaundice, weight gain, enlarged abdomen, and peripheral edema in his legs. He reports fatigue, malaise, and insomnia. His wife and adult son tell the ER physician assistant that his oral intake has been limited to excessive alcohol ingestion and very little food in the last few weeks. He has a history of hypertension being treated with amlodipine 5 mg. Family history is significant for his father having hypertension and an older brother with alcoholism. He has smoked 1 pack of cigarettes daily since he was 18 years old. He has been drinking 12-24 cans of beer daily for the last 15 years. His sclerae are icteric. Abdominal exam shows ascites and caput medusae without hepatomegaly. He has pitting pedal edema bilaterally and a fine tremor in his hands. In the management of this patient, what is the most important factor in regard to his liver disease?

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