What is decompensated cirrhosis?

Decompensated cirrhosis is a term that doctors use to describe the complications of advanced liver disease. People with compensatedcirrhosisoften don’t have any symptoms because theirliveris still properly functioning. As liver function decreases, it can become decompensated cirrhosis.

People with decompensated cirrhosis are nearing end-stageliver failureand are usually candidates for a liver transplant.

Read on to learn more about decompensated cirrhosis, including its symptoms and effects on life expectancy.

Cirrhosis usually doesn’t cause any symptoms in its earlier stages. But as it progresses to decompensated cirrhosis, it can cause:

  • 黄疸
  • fatigue
  • weight loss
  • easy bleeding and bruising
  • bloated abdomen due to fluid accumulation (ascites)
  • swollen legs
  • 混乱，淫乱的演讲或嗜睡（hepatic encephalopathy)
  • nausea and loss of appetite
  • spider veins
  • redness on the palms of the hands
  • 萎缩睾丸and breast growth in men
  • unexplained itchiness

Decompensated cirrhosis is an advanced stage of cirrhosis. Cirrhosis refers to scarring of the liver. Decompensated cirrhosis happens when this scarring becomes so severe that the liver can’t function properly.

Anything that damages the liver can result in scarring, which could eventually turn into decompensated cirrhosis. Themost commoncauses of cirrhosis are:

  • long-term, heavy alcohol consumption
  • chronic hepatitis B or hepatitis C
  • buildup of fat in the liver

Other possible causes of cirrhosis include:

  • buildup of iron
  • cystic fibrosis
  • buildup of copper
  • poorly formed bile ducts
  • autoimmune diseases of the liver
  • bile duct injuries
  • liver infections
  • taking certain medications, such as methotrexate

Generally, doctors will diagnose you with decompensated cirrhosis when you start having cirrhosis symptoms, such as jaundice or mental confusion. They’ll usually confirm the diagnosis by doing blood tests to determineliver function.

They may also take a serum sample to come up with a model for end-stage liver disease (MELD) score. The MELD score is the mostcommonly useddiagnostic tool for advanced liver disease. Scores range from 6 to 40.

Doctors also sometimes do aliver biopsy, which involves taking a small sample of liver tissue and analyzing it. This will help them better understand how damaged your liver is.

They may also use a series of imaging tests to look at the size and shape of your liver and spleen, such as:

  • MRI scans
  • ultrasounds
  • CT scans
  • magnetic resonance elastography or transient elastography, which are imaging tests that detect hardening of the liver

There are limited treatment options for decompensated cirrhosis. At this later stage of liver disease, it’s usually not possible to reverse the condition. But this also means that people with decompensated cirrhosis are often good candidates for aliver transplant.

If you have at least one symptom of decompensated cirrhosis and a MELD score of 15 or higher, a liver transplant isstrongly recommended.

Liver transplants are done with either a partial or whole liver from a donor. Liver tissue can regenerate, so someone can receive a portion of a liver from a live donor. Both the transplanted liver and the donor’s liver will regenerate within a few months .

While a liver transplant is a promising option, it’s a major procedure with a lot of aspects to consider. In most cases, a doctor will refer a prospective patient to a transplant center, where a team of medical professionals will evaluate how well the patient would do with a transplant.

They’ll look at:

  • liver disease stage
  • medical history
  • mental and emotional health
  • support system at home
  • ability and willingness to follow postsurgery instructions
  • likelihood of surviving the surgery

To evaluate all of this, doctors use a variety of tests and procedures, such as:

  • physical exams
  • 多次验血
  • psychological and social evaluations
  • diagnostic tests to evaluate the health of your heart, lungs, and other organs
  • imaging tests
  • drug and alcohol screening
  • 艾滋病毒和肝炎测试

People with alcohol- or drug-related liver disease will likely need to demonstrate their sobriety. In some cases, this might involve showing documentation from an addiction treatment facility.

Regardless of whether someone qualifies for a transplant, a doctor might alsorecommend the followingto improve quality of life and avoid other complications:

  • following a low-salt diet
  • not using recreational drugs or alcohol
  • takingdiuretics
  • taking antiviral medication to manage chronic hepatitis B or C
  • limiting your fluid intake
  • taking antibiotics to treat any underlying infections or prevent new ones
  • taking medications to help blood clot
  • taking medications to improve the flow of blood to the liver
  • undergoing a procedure to remove extra fluid from the abdomen

Decompensated cirrhosis can reduce your life expectancy. Generally, the higher your MELD score, the lower your chances are for surviving another three months.

For example, if you have a MELD score of 15 or lower, you have a95 percentchance of surviving for at least three more months. If you have a MELD score of 30, your three-month survival rate is65 percent. This is why people with a higher MELD score are given priority on the organ donor list.

Getting a liver transplant greatly increases life expectancy. While each case is different, many people return to their usual activities after a liver transplant. The five-year survival rate is about 75 percent.

Decompensated cirrhosis is an advanced form of cirrhosis that’s associated with liver failure. While there aren’t many treatment options for it, a liver transplant can have a big impact on life expectancy.

如果您已被诊断出患有失代偿的肝硬化，请与您的医生讨论您的移植资格。它们还可以将您参考肝病学家，这是一种专门治疗肝脏条件的医生。