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. 1998 Apr;74(870):193–202. doi: 10.1136/pgmj.74.870.193

Liver cirrhosis.

E J Williams 1, J P Iredale 1
PMCID: PMC2360862  PMID: 9683971

Abstract

Liver fibrosis and its related complications continue to represent a significant worldwide healthcare burden. Over the past decade there has been considerable improvement in our understanding of the cellular mechanisms and pathophysiology underlying hepatic fibrosis. This greater insight into the relevant basic sciences may lead to the development of novel treatment strategies designed to block the fibrogenic cascade or even enhance matrix degradation. In addition, there have been significant advances in the management of the complications of cirrhosis, with specific treatments now available for some conditions. Perhaps most notably, liver transplantation is now a highly successful treatment for end-stage liver disease and should be considered in all patients with chronic liver disease.

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Selected References

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  1. Alcolado R., Arthur M. J., Iredale J. P. Pathogenesis of liver fibrosis. Clin Sci (Lond) 1997 Feb;92(2):103–112. doi: 10.1042/cs0920103. [DOI] [PubMed] [Google Scholar]
  2. Aldersley M. A., O'Grady J. G. Hepatic disorders. Features and appropriate management. Drugs. 1995 Jan;49(1):83–102. doi: 10.2165/00003495-199549010-00007. [DOI] [PubMed] [Google Scholar]
  3. Arroyo V., Ginès P., Gerbes A. L., Dudley F. J., Gentilini P., Laffi G., Reynolds T. B., Ring-Larsen H., Schölmerich J. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology. 1996 Jan;23(1):164–176. doi: 10.1002/hep.510230122. [DOI] [PubMed] [Google Scholar]
  4. Arthur M. J., Iredale J. P. Hepatic lipocytes, TIMP-1 and liver fibrosis. J R Coll Physicians Lond. 1994 May-Jun;28(3):200–208. [PMC free article] [PubMed] [Google Scholar]
  5. Arthur M. J. Pathogenesis, experimental manipulation and treatment of liver fibrosis. Exp Nephrol. 1995 Mar-Apr;3(2):90–95. [PubMed] [Google Scholar]
  6. Badalamenti S., Graziani G., Salerno F., Ponticelli C. Hepatorenal syndrome. New perspectives in pathogenesis and treatment. Arch Intern Med. 1993 Sep 13;153(17):1957–1967. doi: 10.1001/archinte.153.17.1957. [DOI] [PubMed] [Google Scholar]
  7. Besson I., Ingrand P., Person B., Boutroux D., Heresbach D., Bernard P., Hochain P., Larricq J., Gourlaouen A., Ribard D. Sclerotherapy with or without octreotide for acute variceal bleeding. N Engl J Med. 1995 Aug 31;333(9):555–560. doi: 10.1056/NEJM199508313330904. [DOI] [PubMed] [Google Scholar]
  8. Bosch J., Bruix J., Mas A., Navasa M., Rodés J. Rolling review: the treatment of major complications of cirrhosis. Aliment Pharmacol Ther. 1994 Dec;8(6):639–657. doi: 10.1111/j.1365-2036.1994.tb00342.x. [DOI] [PubMed] [Google Scholar]
  9. Butterworth R. F. Pathogenesis and treatment of portal-systemic encephalopathy: an update. Dig Dis Sci. 1992 Mar;37(3):321–327. doi: 10.1007/BF01307722. [DOI] [PubMed] [Google Scholar]
  10. Castells A., Bruix J., Bru C., Fuster J., Vilana R., Navasa M., Ayuso C., Boix L., Visa J., Rodés J. Treatment of small hepatocellular carcinoma in cirrhotic patients: a cohort study comparing surgical resection and percutaneous ethanol injection. Hepatology. 1993 Nov;18(5):1121–1126. [PubMed] [Google Scholar]
  11. Chu C. M., Chang K. Y., Liaw Y. F. Prevalence and prognostic significance of bacterascites in cirrhosis with ascites. Dig Dis Sci. 1995 Mar;40(3):561–565. doi: 10.1007/BF02064369. [DOI] [PubMed] [Google Scholar]
  12. Conn H. O., Grace N. D., Bosch J., Groszmann R. J., Rodés J., Wright S. C., Matloff D. S., Garcia-Tsao G., Fisher R. L., Navasa M. Propranolol in the prevention of the first hemorrhage from esophagogastric varices: A multicenter, randomized clinical trial. The Boston-New Haven-Barcelona Portal Hypertension Study Group. Hepatology. 1991 May;13(5):902–912. [PubMed] [Google Scholar]
  13. Dienstag J. L., Perrillo R. P., Schiff E. R., Bartholomew M., Vicary C., Rubin M. A preliminary trial of lamivudine for chronic hepatitis B infection. N Engl J Med. 1995 Dec 21;333(25):1657–1661. doi: 10.1056/NEJM199512213332501. [DOI] [PubMed] [Google Scholar]
  14. Dusheiko G. M. Rolling review--the pathogenesis, diagnosis and management of viral hepatitis. Aliment Pharmacol Ther. 1994 Apr;8(2):229–253. doi: 10.1111/j.1365-2036.1994.tb00283.x. [DOI] [PubMed] [Google Scholar]
  15. Epstein M. The hepatorenal syndrome--newer perspectives. N Engl J Med. 1992 Dec 17;327(25):1810–1811. doi: 10.1056/NEJM199212173272509. [DOI] [PubMed] [Google Scholar]
  16. Forns X., Ginès A., Ginès P., Arroyo V. Management of ascites and renal failure in cirrhosis. Semin Liver Dis. 1994 Feb;14(1):82–96. doi: 10.1055/s-2007-1007300. [DOI] [PubMed] [Google Scholar]
  17. Friedman S. L. Seminars in medicine of the Beth Israel Hospital, Boston. The cellular basis of hepatic fibrosis. Mechanisms and treatment strategies. N Engl J Med. 1993 Jun 24;328(25):1828–1835. doi: 10.1056/NEJM199306243282508. [DOI] [PubMed] [Google Scholar]
  18. Gimson A. E., Ramage J. K., Panos M. Z., Hayllar K., Harrison P. M., Williams R., Westaby D. Randomised trial of variceal banding ligation versus injection sclerotherapy for bleeding oesophageal varices. Lancet. 1993 Aug 14;342(8868):391–394. doi: 10.1016/0140-6736(93)92812-8. [DOI] [PubMed] [Google Scholar]
  19. Graffeo M., Buffoli F., Lanzani G., Donato F., Cesari P., Benedini D., Rolfi F., Paterlini A. Survival after endoscopic sclerotherapy for esophageal varices in cirrhotics. Am J Gastroenterol. 1994 Oct;89(10):1815–1822. [PubMed] [Google Scholar]
  20. Gressner A. M. Perisinusoidal lipocytes and fibrogenesis. Gut. 1994 Oct;35(10):1331–1333. doi: 10.1136/gut.35.10.1331. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Hoofnagle J. H., di Bisceglie A. M. The treatment of chronic viral hepatitis. N Engl J Med. 1997 Jan 30;336(5):347–356. doi: 10.1056/NEJM199701303360507. [DOI] [PubMed] [Google Scholar]
  22. Infante-Rivard C., Esnaola S., Villeneuve J. P. Role of endoscopic variceal sclerotherapy in the long-term management of variceal bleeding: a meta-analysis. Gastroenterology. 1989 Apr;96(4):1087–1092. doi: 10.1016/0016-5085(89)91627-2. [DOI] [PubMed] [Google Scholar]
  23. Iredale J. P. Matrix turnover in fibrogenesis. Hepatogastroenterology. 1996 Jan-Feb;43(7):56–71. [PubMed] [Google Scholar]
  24. Kondrup J., Nielsen K., Hamberg O. Nutritional therapy in patients with liver cirrhosis. Eur J Clin Nutr. 1992 Apr;46(4):239–246. [PubMed] [Google Scholar]
  25. Lai M. Y., Kao J. H., Yang P. M., Wang J. T., Chen P. J., Chan K. W., Chu J. S., Chen D. S. Long-term efficacy of ribavirin plus interferon alfa in the treatment of chronic hepatitis C. Gastroenterology. 1996 Nov;111(5):1307–1312. doi: 10.1053/gast.1996.v111.pm8898645. [DOI] [PubMed] [Google Scholar]
  26. Luca A., García-Pagán J. C., Bosch J., Feu F., Jiménez W., Ginés A., Fernández M., Escorsell A., Arroyo V., Rodés J. Beneficial effects of intravenous albumin infusion on the hemodynamic and humoral changes after total paracentesis. Hepatology. 1995 Sep;22(3):753–758. [PubMed] [Google Scholar]
  27. Martínez Cerezo F. J., Tomás A., Donoso L., Enríquez J., Guarner C., Balanzó J., Martínez Nogueras A., Vilardell F. Controlled trial of tamoxifen in patients with advanced hepatocellular carcinoma. J Hepatol. 1994 Jun;20(6):702–706. doi: 10.1016/s0168-8278(05)80138-2. [DOI] [PubMed] [Google Scholar]
  28. McCormick P. A., Dick R., Burroughs A. K. Review article: the transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of portal hypertension. Aliment Pharmacol Ther. 1994 Jun;8(3):273–282. doi: 10.1111/j.1365-2036.1994.tb00288.x. [DOI] [PubMed] [Google Scholar]
  29. McCormick P. A., Dick R., Chin J., Irving J. D., McIntyre N., Hobbs K. E., Burroughs A. K. Transjugular intrahepatic portosystemic stent-shunt. Br J Hosp Med. 1993 Jun 2;49(11):791-3, 796-7. [PubMed] [Google Scholar]
  30. McNair A. N., Tibbs C. J., Williams R. Hepatology. BMJ. 1995 Nov 18;311(7016):1351–1355. doi: 10.1136/bmj.311.7016.1351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Merkel C., Marin R., Enzo E., Donada C., Cavallarin G., Torboli P., Amodio P., Sebastianelli G., Sacerdoti D., Felder M. Randomised trial of nadolol alone or with isosorbide mononitrate for primary prophylaxis of variceal bleeding in cirrhosis. Gruppo-Triveneto per L'ipertensione portale (GTIP) Lancet. 1996 Dec 21;348(9043):1677–1681. doi: 10.1016/s0140-6736(96)05406-2. [DOI] [PubMed] [Google Scholar]
  32. Perrillo R. P., Schiff E. R., Davis G. L., Bodenheimer H. C., Jr, Lindsay K., Payne J., Dienstag J. L., O'Brien C., Tamburro C., Jacobson I. M. A randomized, controlled trial of interferon alfa-2b alone and after prednisone withdrawal for the treatment of chronic hepatitis B. The Hepatitis Interventional Therapy Group. N Engl J Med. 1990 Aug 2;323(5):295–301. doi: 10.1056/NEJM199008023230503. [DOI] [PubMed] [Google Scholar]
  33. Perrillo R. P. Treatment of chronic hepatitis B with interferon: experience in western countries. Semin Liver Dis. 1989 Nov;9(4):240–248. doi: 10.1055/s-2008-1040517. [DOI] [PubMed] [Google Scholar]
  34. Pichlmayr R., Weimann A., Ringe B. Indications for liver transplantation in hepatobiliary malignancy. Hepatology. 1994 Jul;20(1 Pt 2):33S–40S. doi: 10.1016/0270-9139(94)90271-2. [DOI] [PubMed] [Google Scholar]
  35. Record C. O. Neurochemistry of hepatic encephalopathy. Gut. 1991 Nov;32(11):1261–1263. doi: 10.1136/gut.32.11.1261. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Shiffman M. L., Jeffers L., Hoofnagle J. H., Tralka T. S. The role of transjugular intrahepatic portosystemic shunt for treatment of portal hypertension and its complications: a conference sponsored by the National Digestive Diseases Advisory Board. Hepatology. 1995 Nov;22(5):1591–1597. [PubMed] [Google Scholar]
  37. Silk D. B., O'Keefe S. J., Wicks C. Nutritional support in liver disease. Gut. 1991 Sep;Suppl:S29–S33. doi: 10.1136/gut.32.suppl.s29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Solà R., Andreu M., Coll S., Vila M. C., Oliver M. I., Arroyo V. Spontaneous bacterial peritonitis in cirrhotic patients treated using paracentesis or diuretics: results of a randomized study. Hepatology. 1995 Feb;21(2):340–344. doi: 10.1002/hep.1840210212. [DOI] [PubMed] [Google Scholar]
  39. Stiegmann G. V., Goff J. S., Michaletz-Onody P. A., Korula J., Lieberman D., Saeed Z. A., Reveille R. M., Sun J. H., Lowenstein S. R. Endoscopic sclerotherapy as compared with endoscopic ligation for bleeding esophageal varices. N Engl J Med. 1992 Jun 4;326(23):1527–1532. doi: 10.1056/NEJM199206043262304. [DOI] [PubMed] [Google Scholar]
  40. Sung J. J., Chung S. C., Lai C. W., Chan F. K., Leung J. W., Yung M. Y., Kassianides C., Li A. K. Octreotide infusion or emergency sclerotherapy for variceal haemorrhage. Lancet. 1993 Sep 11;342(8872):637–641. doi: 10.1016/0140-6736(93)91758-e. [DOI] [PubMed] [Google Scholar]
  41. Toledo C., Salmerón J. M., Rimola A., Navasa M., Arroyo V., Llach J., Ginès A., Ginès P., Rodés J. Spontaneous bacterial peritonitis in cirrhosis: predictive factors of infection resolution and survival in patients treated with cefotaxime. Hepatology. 1993 Feb;17(2):251–257. [PubMed] [Google Scholar]
  42. Wilkinson S. P., Moore K. P., Arroyo V. Pathogenesis of ascites and hepatorenal syndrome. Gut. 1991 Sep;Suppl:S12–S17. doi: 10.1136/gut.32.suppl.s12. [DOI] [PMC free article] [PubMed] [Google Scholar]

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