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Conditions

Liver cirrhosis

The extreme stage of liver fibrosis with irreversible tissue restructuring

Cirrhosis — scar nodules and fibrosis of liver tissue

Cirrhosis is the final stage of chronic liver disease, when normal tissue is replaced by scars and regenerative nodules (fibrosis). This is stage F4 on the METAVIR scale — the maximum degree of scarring.

The scars disrupt both the liver's function and the blood flow through it (portal hypertension). The leading causes are viral hepatitis, alcohol and NASH.

Compensated and decompensated

Compensated cirrhosis — the liver is damaged, but the remaining healthy cells are enough to do the work. The person often feels normal, although portal hypertension may already be present. This stage lasts for years.

Decompensated cirrhosis — there are so many scars that the liver cannot cope. Life-threatening complications appear: ascites (fluid in the abdomen), bleeding from esophageal varices, hepatic encephalopathy (confusion) and jaundice.

How it is detected

Today a biopsy is needed less often: elastography (measuring liver stiffness), calculated indices (FIB-4) and ultrasound are widely used. A decline in function is indicated by a fall in albumin, a rise in bilirubin and a prolonged INR.

Once cirrhosis is established, regular screening for liver cancer and varices is needed.

Can it be reversed

Advanced cirrhosis is irreversible, but its early stages can be stabilized and the scarring even partly reduced if the cause is removed — for example, by curing hepatitis C or completely giving up alcohol.

Treatment targets the cause, prevention and control of complications; in severe cases transplantation is considered.

Reference ranges

Reference points for the stage and severity of cirrhosis.

Fibrosis on METAVIRF4 = cirrhosis (the maximum on the F0–F4 scale)
Compensatedfunction preserved, often without symptoms
Decompensatedascites, variceal bleeding, encephalopathy, jaundice
Liver stiffness (elastography)roughly > 12–15 kPa indicates marked fibrosis/cirrhosis
Important: Severity is assessed with the Child–Pugh and MELD scores; the specific thresholds depend on the cause and the method of investigation.

Calculate using this marker

Calculators where Cirrhosis is used directly:

FIB-4 (Liver Fibrosis) A first-line check for liver scarring, adjusted for age Open FibroTest A non-invasive estimate of fibrosis stage — an alternative to biopsy Open NAFLD Fibrosis Score (NFS) Assesses advanced fibrosis in NAFLD from simple labs and BMI Open Liver Steatosis Score (LSS) A calculated alternative to elastography: fibrosis likelihood from blood tests Open

Frequently asked questions

Can cirrhosis be cured?

Advanced cirrhosis cannot be removed completely. But an early stage can be stabilized and partly reversed if the cause is removed (treating hepatitis, giving up alcohol, losing weight).

How long do people live with cirrhosis?

It all depends on the stage. Compensated cirrhosis is compatible with years and decades of life; with decompensation the prognosis is worse, and then liver transplantation is discussed.

Related terms

Liver fibrosis Scarring of the liver — the replacement of healthy tissue by connective tissue Liver stiffness The firmness of liver tissue; it rises as scarring (fibrosis) progresses NASH Non-alcoholic steatohepatitis — the inflammatory form of fatty liver disease Alcoholic liver disease (ALD) Liver damage due to alcohol consumption Cholestasis the stasis of bile due to impaired outflow Steatohepatitis Fatty liver with inflammation METAVIR A liver fibrosis staging scale from F0 to F4 Albumin The main plasma protein — a marker of protein status and liver function Bilirubin A bile pigment; it rises when liver function is impaired

Sources

  1. MedlinePlus — Cirrhosis
  2. NIDDK (NIH) — Cirrhosis
  3. StatPearls (NCBI) — Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)
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This content is educational and does not replace consultation with a physician. Reference ranges may vary depending on the laboratory and method — rely on the ranges stated on your own test report.
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