title: Complications of cirrhosis. A 50 years flashback.
abstract: In patients with cirrhosis and portal hypertension, it is largely the frequency and severity of complications relating to the diseased liver, degree of portal hypertension and hemodynamic derangement that determine the prognosis. It can be considered as a multiple organ failure that apart from the liver involves the heart, lungs, kidneys, the immune systems and other organ systems. Progressive fibrosis of the liver and subsequent metabolic impairment leads to a systemic and splanchnic arteriolar vasodilatation. With the progression of the disease development of portal hypertension leads to formation of esophageal varices and ascites. The circulation becomes hyperdynamic with cardiac, pulmonary as well as renal consequences for dysfunction and reduced survival. Infections and a changed cardiac function known as cirrhotic cardiomyopathy may be involved in further aggravation of other complications such as renal failure precipitating the hepatorenal syndrome. Patients with end-stage liver disease and related complications as for example the hepatopulmonary syndrome can only radically be treated by liver transplantation.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine 239, Faculty of Health Sciences, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, University of Copenhagen , Hvidovre , Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Møller
authors.forename: Flemming
authors.initials: F
authors.lastname: Bendtsen
mesh_terms: D018450:Disease Progression; D004932:Esophageal and Gastric Varices / Q000209:etiology*; D005544:Forecasting; D006530:Hepatorenal Syndrome / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications*; D011379:Prognosis
keywords: arterial vasodilatation; ascites; cirrhosis; cirrhotic cardiomyopathy; esophageal varices; hemodynamics; hepatic encephalopathy; hepatopulmonary syndrome; hepatorenal syndrome; portal hypertension; portopulmonary hypertension; vasoactive substances