
How To Determine The Severity Of Liver Cirrhosis Based On Liver Biopsy?

Liver transplant may be needed at a later stage.
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query and after going through reports, my opinion is as follows:
1. The Child-pugh functional classification is used to assess the severity of cirrhosis. It looks into ascites, bilirubin, albumin, prothrombin time and encephalopathy to grade it. It is graded as well compensated, some functional compromise and decompensated.
There is an histological grading based on Laennec grading of fibrosis, which has mild, moderate and severe types. This is based on liver biopsy. However, the functional grading is more relevant towards management.
2. Looking at the values provided, a well-compensated stage can be thought of.
3. Management involves managing complications of ascites, encephalopathy, portal hypertension and internal bleeding commonly. These can be life-threatening if not managed properly.
4. Cirrhosis is irreversible. Progression can be delayed through avoiding any further hepatic damage. Anti-fibrotic agents (all medications still in research stage), if prescribed any by your doctor, can be taken to delay further fibrosis. Please remember, no medication at present can reverse cirrhosis. Vit E supplements could be helpful.
5. If the complications are severe or it becomes decompensated phase, then liver transplant is definitely needed. Usually at the end, everybody surviving requires a liver transplant.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM


If anti-fibrotic medications are prescribed, can be taken.
Detailed Answer:
Hi,
Thanks for asking again.
If there is no complications like ascites, hemorrhage, infection or encephalopathy and the liver functions remain the same, and if further liver damage is stopped, the same compensated stage may continue for another 2-5 years very easily.
However, the cause of cirrhosis is very important in management purpose. If the cause is not identified, difficult to talk about prognosis.
Yes, if medications are prescribed, patient at present if fully stable can go for medications. Until there is no complications and well managed, liver transplant won't be necessary.
Follow-up with clinical, radiological and laboratory investigations necessary to evaluate medical line of management. Need to discuss with your hepatologist regarding follow-up.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM


Liver cirrhosis with dilated portal vein & mild splenomegaly.
Still early stages, can be managed well with good liver care.
Detailed Answer:
Hi,
Thanks for asking again.
Based on details provided, it appears to be in well-compensated phase. Most of the values are near normal, with mild changes.
Depending on the development of portal vein hypertension or liver failure leading onto encephalopathy, further management will vary.
At present, still early stages. Prognosis will be good with antifibrotic medications, avoiding hepatotoxic agents and avoiding/ management of the cause of present cirrhosis.
If managed well, the present stage of well compensated can continue for another 2-5 years. Hope you develop no complications.
Take care.
Hope it helps.
If you do not have any further queries, you can close the discussion and rate the answer.
Any further queries, here to help again.
Dr. Prakash HM

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