Cirrhosis is the end-stage of progressive liver fibrosis. Cirrhosis is serious because of the importance of the organ it affects.
During this process the functional organ tissue deteriorates. The surviving liver cells (hepatocytes) multiply in attempts to regenerate liver tissue and form "islands" (nodules) of living liver cells that are separated by scar tissue.
As liver cells give way to tough scar tissue, the organ loses its ability to function properly.
These islands of living cells (nodules) have a reduced blood supply due to surrounding scar tissue, resulting in impaired function of hepatocytes inside nodules and the liver as a whole.
The scar tissue constricts liver blood vessels and impedes the flow of blood through the liver and slows the processing of nutrients, hormones, drugs and naturally produced toxins. It also slows the production of proteins and other substances made by the liver for the body.
When blood flow through the liver becomes hampered enough portal hypertension will occur (high blood pressure in the veins which bring venous blood to the liver from the stomach, intestines, pancreas, esophagus and spleen).
Besides all liver functions as well as stomach and bowel function are affected. Most patients die from cirrhosis in the fifth or sixth decade of life.
Various scoring systems are used to assess the severity of disease and make the prognosis in patients with cirrhosis. The modified Child-Pugh score, which ranks disease severity on the basis of signs and the findings of liver function tests, has been shown to predict survival.
Based on the total point score, patients are categorized into one of three stages. Those with Child class A cirrhosis may survive as long as 15 to 20 years, whereas those with Child class C cirrhosis may survive only one to three years.
Historically, treatments for hepatic fibrosis have been directed against specific causes of chronic liver injury, and include for example corticosteroids for autoimmune hepatitis, interferon for hepatitis B and C, and iron depletion for haemochromatosis.
Once treatments become ineffective, a liver transplant has been considered until the present.
However the underlying disease factor of deterioration of liver functions is progressive liver fibrosis; it is the driving gear of all chronic degenerative liver diseases which results ultimately in morbidity and mortality.
And the most efficacious treatment for cirrhosis according to our practice is transplantation of cultured hepatoblasts. In most circumstances, liver cell transplantation along with a proper adjuvant therapy
(according to an individual disease features) reduces and reverse the harmful affects of advanced liver fibrosis and cirrhosis, and can prevent the need for a liver transplant.
What Complications Are Associated With Cirrhosis?
Complications associated with cirrhosis include:
- Variceal bleeding. Variceal bleeding is caused by portal hypertension, which is an increase in the pressure within the portal vein. This increase in pressure is caused by a blockage of blood flow through the liver as a result of cirrhosis.
Increased pressure in the portal vein causes branches of portal vein to enlarge (varices), such as those in the esophagus and stomach, to bypass the blockage. These varices become fragile and can bleed easily,
causing severe hemorrhaging and result in fluid buildup in the abdomen.
- Confused thinking and other mental changes (hepatic encephalopathy). Hepatic encephalopathy most often occurs when cirrhosis has been present for a long time.
Toxins produced in our intestines and ammonia are normally detoxified by the liver, but once cirrhosis occurs, the liver cannot detoxify as well. Toxins get into the bloodstream and can deteriorate brain function and cause confusion, changes in behavior and even coma.
Other serious complications of cirrhosis include:
- Kidney failure.
- Reduced oxygen in the blood.
- Changes in blood counts.
- Increased risk of infections.
- Excessive bleeding and bruising.
- Breast enlargement in men.
- Premature menopause.
- Loss of muscle mass.
Synonyms and related keywords: end-stage liver disease, ESLD, end stage liver disease, end-stage liver failure, end stage liver failure, ESLF, alcoholism, alcoholic complications, cirrhotic, cirrhotic liver,
cirrhosis, chronic liver disease, chronic liver failure, CLF, fulminant hepatic failure, FHF, alcoholic liver disease, hepatitis, hepatitis C virus, hepatitis B virus, viral hepatitis, hepatic fibrosis, portal hypertension,
ascites, progressive liver fibrosis, spontaneous bacterial peritonitis, SBP, hepatic encephalopathy, hepatocellular carcinoma, HCC, cholangiocarcinoma, liver transplant, liver transplantation, orthotopic liver transplantation,
OLT, coagulopathy, variceal bleeding, hepatitis B, autoimmune hepatitis, primary biliary cirrhosis, secondary biliary cirrhosis, chronic extrahepatic bile duct obstruction, primary sclerosing cholangitis, hemochromatosis,
Wilson disease, alpha-1 antitrypsin deficiency, granulomatous disease, sarcoidosis, drug-induced liver disease, venous outflow obstruction, Budd-Chiari syndrome, veno-occlusive disease, nonalcoholic fatty liver disease, non-alcoholic fatty liver disease, NAFLD, necroinflammation