Decompensated cirrhosis

Decompensated cirrhosis is the final stage of the hepatitis C cycle that relates to liver damage. It is usually at this point that there is a significant risk of life threatening complications. The liver at this stage will be covered with nodules and shrunken in size. Once decompensated cirrhosis is established there is usually a very high frequency of readmissions to hospital. There is also a strong likelihood of developing complications or illness additional to the initial complication.

Because the liver is crucial for so many metabolic activities, cirrhosis impacts on a wide range of the bodys functions, including nutrient and hormone metabolism, blood clotting, and processing of ammonia and other toxic wastes. Many of the symptoms of decompensated cirrhosis are directly related to disruption of these functions. So resilient is the liver that it only finally fails when about 80-90% of the liver is seriously damaged but with decompensated cirrhosis this stage is close at hand.

In one study of patients with decompensated cirrhosis 200 patients were followed over an average of three years. The most common first complication was ascites (48%), followed by gastrointestinal bleeding caused by portal hypertension (33%), severe bacterial infection about (15%) and encephalopathy (5%). 17% of the patients developed hepatocellular carcinoma. 43% of all the patients died.

This study estimated the probability of survival after diagnosis of decompensated cirrhosis was about 80% after one year but only 50% after 5 years.

Apart from the risk of liver cancer (HCC) and liver failure the two most serious complications of decompensated cirrhosis are the formation of abnormal veins called varices and hepatic encephalopathy. Varices are caused by the build up of pressure in the portal vein (portal hypertension). Hepatic encephalopathy is caused by an accumulation of toxins in the blood that can enter the brain and result in mental confusion and coma. (See portal hypertension for more)