Cirrhosis

Basics

Cirrhosis is the end stage of progressive hepatic necrosis, fibrosis, and regenerative nodule formation that may occur as a result of many different liver diseases.
Results in distortion of liver architecture and compression of hepatic vascular and biliary structures
Cirrhosis is clinically defined by outcomes as either compensated or decompensated:
- Compensated cirrhosis: typically asymptomatic with normal synthetic function
- Decompensated cirrhosis: defined as loss of normal synthetic function, development of jaundice, and/or the clinical complications of portal hypertension such as ascites, variceal hemorrhage, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, and portopulmonary hypertension
In its decompensated form/advanced form, cirrhosis is irreversible and often requires liver transplantation for survival of the patient.

There are varying causes of cirrhosis; accordingly, no specific epidemiologic pattern can be identified.
Cirrhosis due to chronic hepatitis C virus (HCV) infection, alcoholic liver disease, and nonalcoholic fatty liver disease (NAFLD) are the most common indications for liver transplantation in adults.
Biliary cirrhosis due to biliary atresia is the most common indication for liver transplantation in children.

Many distinct genetic disorders can cause cirrhosis, such as Wilson disease and hereditary hemochromatosis.
Human leukocyte antigen (HLA) associations have been identified in several autoimmune disorders, including sclerosing cholangitis and autoimmune hepatitis.

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