Cirrhosis

Description

• 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.

Epidemiology

• 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.

Risk Factors