Even at Mayo, didn't they do general labs with liver enzymes? When I went, the IMS sent me to multiple specialist's as tests showed one thing or another and not associated with my primary reason for going. Maybe Mayo works differently now but it seems unlikely they would ignore basic lab tests. Were you at Mayo when you had this shortness of breath? Rheumatology wouldn't treat liver disease. At minimum you should have been referred to a primary doctor and maxium a hepatologist. I hope you're wrong that you have such advanced liver disease. In your shoes I would find a good primary care physician to direct your care. That is what they are good for. You should be able to get in with a primary within a couple weeks.