Chronic liver disease and cirrhosis are listed among the 10 leading causes of death in the US.
Cirrhosis is the pathologic end-stage of any chronic liver disease and most commonly results from chronic hepatitis C and B, alcohol misuse, and nonalcoholic fatty liver disease.
The main complications of cirrhosis are related to the development of liver insufficiency and portal HTN and include ascites, variceal hemorrhage, jaundice, portosystemic encephalopathy, hepatorenal and hepatopulmonary syndromes, and the development of hepatocellular carcinoma.
Once a patient with cirrhosis develops signs of decompensation, survival is significantly impaired.
The management of cirrhosis is aimed at treating underlying liver disease, avoiding superimposed injury, and managing complications. Timely referral for liver transplantation is the only curative treatment option for patients with decompensated cirrhosis.
Cirrhosis is a diffuse pathologic process, characterized by fibrosis and conversion of normal liver architecture to structurally abnormal nodules known as regenerative nodules.   It can arise from a variety of causes and is the final stage of any chronic liver disease. It leads to portal hypertension, liver insufficiency, and hepatic failure. In general, it is considered to be irreversible in its advanced stages.
College of Health Solutions
Arizona State University
KDL is an unpaid advisor for Intercept Pharmaceuticals and Shire Pharmaceuticals.
Dr Keith D. Lindor would like to gratefully acknowledge Dr Flavia Mendes, a previous contributor to this monograph. FM declares that she has no competing interests.
Assistant Professor of Medicine
University of Chicago
Center for Liver Disease
NR declares that she has no competing interests.
Clinical Assistant Professor
Division of Gastroenterology Hepatology and Nutrition
University of Florida
CL declares that she has no competing interests.
Hon Professor in Medicine
Associate Medical Director NHSBT
Queen Elizabeth Hospital
JN declares that he has no competing interests.
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