EUH Morning Report: What are the causes of decompensated liver failure?

The Bottom Line: “The occurrence of more than one causative factor in a single patient can lead to more rapid progression to cirrhosis. Aetiology might also influence the comorbidities associated with cirrhosis.”
“Cirrhosis develops after a long period of inflammation that results in replacement of the healthy liver parenchyma with fibrotic tissue and regenerative nodules, leading to portal hypertension. The disease evolves from an asymptomatic phase (compensated cirrhosis) to a symptomatic phase (decompensated cirrhosis), the complications of which often result in hospitalisation, impaired quality of life, and high mortality.” (Gines)

EUH Morning Report: What are the management strategies for decompensated cirrhosis?

The Bottom Line: “[T]he overall management of decompensated cirrhosis can be addressed using two approaches. The first approach is the suppression of the etiological factor(s) that has caused liver inflammation and cirrhosis development, whereas the second approach is based on targeting key factors of pathogenesis of cirrhosis decompensation and progression.” (EASL, 2018, pgs. 407-408)