Liver is one of the vital organs of our body. Morphologically, it is reddish brown in color and is the largest organ which performs 500 different functions. Some of its important functions are metabolism of fats, production of proteins, fighting infection and detoxification of chemicals before they are removed from the body. Damage to the liver is caused by infections, toxins and various chemicals. If damage is not treated then, it leads to liver failure. Cirrhosis is the end-stage of liver damage. Liver cirrhosis is a major public health problem worldwide.
What is Liver Cirrhosis?
Liver is made of cells called hepatocytes which perform important functions. Liver cells get damaged by different types of liver diseases caused by hepatitis infection and excessive alcoholism. The end-stage of liver damage is irreparable and is called Cirrhosis. This complicated medical condition is characterized by formation of fibrosis and scarring of the liver tissue. The smooth liver tissue is replaced by irregular nodules which makes the liver hard. This long lasting injury causes loss of normal hepatocytes due to which the liver is not able to function well. In cirrhosis, the normal liver tissue is replaced by scar tissue which finally leads to liver failure and thereby to death. It is called as end-stage liver damage since it comes after different stages of liver damage which involve inflammation, steatosis (fatty liver), increased hardness and scarring of liver. Some of the causes of cirrhosis include excessive intake of alcohol, being overweight, a long term (chronic) infection of Hepatitis B or Hepatitis C, haemochromatosis –an inherited liver disease, problem with immune system which leads to liver disease.
How Long Can You Live With Cirrhosis Of The Liver?
Cirrhosis is a serious degenerative disease. It is slow but progressive damage of the liver. There are two major types of cirrhosis namely compensated and decompensated. Compensated cirrhosis is where the liver is able to sustain damage and perform its important functions. Life expectancy in compensated cirrhosis is good. While in decompensated cirrhosis, liver is not able to perform its functions properly. Patients with decompensated cirrhosis have serious complications such as renal failure, coughing of blood, ascites, infections and change in mental status (encephalopathy).
In general, a person suffering with liver cirrhosis has a short life span. It is difficult to predict the exact life expectancy of a person suffering from liver cirrhosis, since the course of disorder is variable from patient to patient. Some of the reasons for variability in life expectancy are the cause of cirrhosis, the percentage of cirrhosis, the degree of liver reserve and how a patient responds to the given treatment regimen. Patients with compensated cirrhosis have better life expectancy without a liver transplant. While a patient suffering from decompensated cirrhosis with complications has poor prognosis. Again, depending on stage of cirrhosis, patient with decompensated cirrhosis will have life expectancy. Usually patients with stage 4 cirrhosis which is also called End-Stage liver disease have complete liver damage and liver transplant is only option for survival. However, if the symptoms are very severe then the liver transplant may not be helpful and patients have to accept liver disease death process.
There are systems (tools) to determine the prognosis of a patient with liver cirrhosis. These tools grade cirrhosis according to its severity.
- Childs Pugh Score indicates that there are three major types of cirrhosis as Type A, B and C. Five symptoms of liver disease are used in the score, where each of them is scored from 1 to these clinical symptoms are ascites and encephalopathy in addition with blood test results for bilirubin, albumin and clotting. The score determines the type of cirrhosis as
- Class A means relatively mildly severe liver disease. For a patient with Class A cirrhosis and a score of 5-6 points is predicted a life expectancy of 15-20 years.
- Class B means moderately severe liver disease. For a patient with Class B cirrhosis and score of 7-9 points is predicted to have life expectancy of 6- 10 years.
- Class C means most severe liver disease. For a patient with Class C cirrhosis has poor prognosis and life expectancy of 1-3 years.
Thus, Class A and Class B are low and moderate risk, respectively and have better prognosis as compared to Class C cirrhosis.
- In addition, there is another system called MELD (model of end-stage liver disease) which is used to determine which patients need liver transplant. It uses blood test values for bilirubin, creatinine and clotting.
Overall, on any of these systems, a higher score mean short life expectancy for patient with liver cirrhosis.
Due to liver transplant the life expectancy of people with cirrhosis has improved. However, liver transplant is not possible in all cases. Some of the shortcomings include:
- The availability of liver as organ for transplantation is limited.
- It is an expensive procedure.
- Liver transplantation is a complex surgical process and the person is too weak to undergo such procedure.
- The administration of immunosupressants often causes side-effects.
- Just because liver transplantation works for some patients it may be applicable for all patients with liver damage.
Prevention for Liver Cirrhosis
The following changes needs to be taken to prevent liver cirrhosis from happening:
- Prevent taking medications that will damage liver
- Avoid consumption of alcohol
- To consume well balanced diet with low sodium content
- To get vaccinated against flu and hepatitis A and B
- To maintain hygiene in order to prevent contacting infections.
Liver cirrhosis is a serious health problem and is often underestimated. Its incidence is increasing due to excessive alcoholism and viral etiology. Liver cirrhosis, if recognized early (in some cases), can be prevented from causing liver damage. The excessive alcohol habit has to be decreased and antiviral medications against hepatitis B do show good results. Liver transplant has improved the life expectancy of patients with liver cirrhosis; however this procedure has its limitations. Thus, having balanced diet, careful blood transfusions and avoiding excessive alcohol can prevent liver cirrhosis.