9 September, 2020
Cirrhosis: Cause, Treatment, and When to Consider Liver Transplantation
Cirrhosis is a chronic liver disease, the ultimate cause of ongoing liver damage caused by long-term illness. It is characterized by the presence of fibrosis (scars) in the liver that cause liver dysfunction. These scars appear when, due to the presence of a chronic injury or inflammation, the liver repairs itself, producing scar tissue. This type of tissue, different from the original, decompensates the liver function, producing cirrhosis.
CAUSES OF CIRRHOSIS
As we have said, the cause of cirrhosis is prolonged liver damage caused by disease. These include:
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Metabolic diseases
A common cause of cirrhosis are diseases related to the infiltration of fat within the liver, which we call hepatic steatosis. (For example, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), among others.)
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Viral hepatitis
Another common cause of cirrhosis is a chronic infection with hepatitis B and / or hepatitis C.
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Alcohol consumption or alcoholism
One of the best known causes is the continued or chronic consumption of alcohol. Alcoholic liver cirrhosis is one of the most common types of cirrhosis.
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Autoimmune diseases
Finally, the immune system can be a cause of cirrhosis when, due to the presence of an autoimmune disease, liver cells are attacked and destroyed.
TREATMENT OF CIRRHOSIS
Treatment of liver cirrhosis depends on a number of factors. On the one hand, the cause of cirrhosis will largely define the type of treatment. On the other hand, the damage caused to the liver and its condition will also determine the type of treatment.
The goal of treatment is generally to slow the formation and progression of scar tissue, as well as to treat symptoms of cirrhosis resulting from liver dysfunction.
Thus, the treatment for cirrhosis will be:
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In patients with cirrhosis due to viral hepatitis (hepatitis b or c)
Antiviral treatments that reduce inflammation and reduce the amount and evolution of fibrosis.
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In patients with cirrhosis due to alcohol consumption
In cases of alcoholic liver cirrhosis, the main treatment is abstinence. With this measure, they tend to reduce inflammation and in some cases liver fibrosis.
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In patients with cirrhosis due to steatohepatitis
Faced with liver cirrhosis caused by a metabolic disease such as steatohepatitis, the initial treatment will be weight loss, alcohol withdrawal, and physical exercise.
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In patients with cirrhosis due to autoimmune diseases
In those patients who suffer from this disease caused by their immune system, treatment in many cases will be based on steroids.
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In patients with advanced cirrhosis
Patients with advanced liver cirrhosis should be carefully evaluated and monitored. When the time comes, it will be necessary to decide if they are a good candidate for a liver transplant.
WHEN SHOULD A LIVER TRANSPLANTATION FOR CIRRHOSIS BE CONSIDERED?
In some cases, advanced cirrhosis can produce symptoms and complications that greatly affect the life of the patient or that can even lead to death. In these cases, the possibility of a liver transplant must be considered.
A liver transplantation would be considered for those patients with advanced liver cirrhosis who develop complications such as:
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Excess retention of fluids
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Kidney failure
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Hepatic encephalopathy
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Digestive bleeding due to portal hypertension
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Liver cancer
