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Liver Failure Life Expectancy: Cirrhosis of the Liver Life Expectancy – Stages, Prognosis, and More

by alexxlab

What is the life expectancy for cirrhosis of the liver? How do the stages of cirrhosis affect prognosis? What diagnostic tests are used to determine liver cirrhosis stage and life expectancy?

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Understanding Cirrhosis of the Liver

Cirrhosis of the liver is a serious condition that causes permanent scarring and damage to the liver. The liver is a vital organ, second in size only to the skin, and plays a crucial role in human health. Cirrhosis impairs the liver’s ability to function properly, putting both the organ and the patient’s life at risk.

Cirrhosis is not uncommon, with the Department of Veterans Affairs estimating that 4.9 million people in the United States are living with this condition. The National Institute for Diabetes and Digestive and Kidney Diseases states that at least 1 in 400 adults in the U.S. has cirrhosis, and the actual number may be even higher as many cases go undiagnosed until advanced symptoms develop.

Stages of Cirrhosis and Life Expectancy

There are two main stages of cirrhosis: compensated and decompensated. Compensated cirrhosis is when the liver is still able to function, and patients may not show any symptoms. The life expectancy for those with compensated cirrhosis is around 9-12 years. However, 5-7% of individuals with compensated cirrhosis will develop symptoms and progress to the decompensated stage each year.

Decompensated cirrhosis is when the liver can no longer function properly, and patients experience various symptoms and complications. The life expectancy for those with decompensated cirrhosis is greatly reduced compared to those in the compensated stage. In these cases, healthcare professionals may recommend referral for a potential liver transplant.

Diagnostic Tests and Scoring Systems

Physicians use diagnostic tests and scoring systems to determine an individual’s stage of cirrhosis and project their life expectancy. The Child-Turcotte-Pugh (CTP) system awards points based on factors such as the buildup of fluid in the abdomen, brain dysfunction, albumin levels, bilirubin levels, and blood clotting time. Patients are then assigned to one of three classes (A, B, or C) based on their CTP score, which correlates with their projected 3-month, 1-year, and 2-year survival rates.

The Model for End-Stage Liver Disease (MELD) is another scoring system used to estimate life expectancy and prioritize liver transplants. MELD scores are calculated based on bilirubin, INR, and creatinine levels, with higher scores indicating a greater risk of mortality.

Improving Life Expectancy with Cirrhosis

Following an effective treatment plan is crucial for individuals with cirrhosis to increase their life expectancy. This may include addressing the underlying cause of the cirrhosis, such as avoiding alcohol for those with alcohol-related liver disease, or taking antiviral medications for those with viral hepatitis-related cirrhosis.

Regularly monitoring the progression of the condition and managing any complications that arise is also essential. Medications and procedures to treat cirrhosis symptoms can include diuretics, laxatives, beta-blockers, and even liver transplantation in severe cases.

Prognosis and Progression of Cirrhosis

Cirrhosis is a progressive condition, but some individuals may be able to move from the decompensated, or symptomatic, stage back to the asymptomatic, compensated stage. This is a challenging process, and the prognosis for those with cirrhosis can vary depending on the stage, underlying cause, and effectiveness of treatment.

Conclusion

Cirrhosis of the liver is a serious condition that can significantly impact an individual’s life expectancy. Understanding the stages of cirrhosis, the diagnostic tools used to assess prognosis, and the importance of effective treatment and management of the condition is crucial for individuals living with this liver disease.

Key Takeaways

  • Cirrhosis of the liver is a serious condition that causes permanent scarring and damage to the liver, affecting its function.
  • There are two main stages of cirrhosis: compensated (asymptomatic) and decompensated (symptomatic), with different life expectancies.
  • Diagnostic tests and scoring systems, such as the Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD), are used to determine the stage of cirrhosis and project life expectancy.
  • Effective treatment, including addressing the underlying cause and managing complications, is crucial for improving life expectancy in individuals with cirrhosis.
  • While cirrhosis is progressive, some individuals may be able to move from the decompensated stage back to the compensated stage, though this is a challenging process.

Cirrhosis of the liver life expectancy: Stages, prognosis, and more

Cirrhosis of the liver is a serious condition, causing scarring and permanent damage to the liver. Life expectancy depends on the stage and type of liver cirrhosis.

The liver is the second largest organ in the human body and one of the most important for human health. Cirrhosis puts both a person’s liver and life at risk.

Despite its severity, the condition is not rare. The Department of Veterans Affairs estimates there are 4.9 million people in the United States living with cirrhosis.

The National Institute for Diabetes and Digestive and Kidney Diseases state at least 1 in 400 adults in the U.S. has cirrhosis. This number could be even higher, as many people do not receive a diagnosis until they develop advanced symptoms.

Keep reading to explore the life expectancy for cirrhosis by its stage, including diagnosis information and coping tips.

Cirrhosis is a serious condition that causes scarring and permanent damage to the liver. Over time, the disease keeps the organ from working properly and eventually causes failure. Cirrhosis puts people at greater risk for:

  • bruising and bleeding easily
  • high blood pressure in the liver, or portal hypertension, which can then lead to enlarged veins and internal bleeding, fluid build-up in the abdomen, swelling in the lower extremities, and difficulty thinking
  • urinary tract infection
  • increased sensitivity to medication
  • jaundice, giving people a yellow tinge in their eyes — this discoloration can also affect the skin of those with lighter skin
  • pneumonia
  • liver cancer
  • osteoporosis
  • gallstones
  • type 2 diabetes

There are two stages in cirrhosis: compensated and decompensated.

Compensated cirrhosis: People with compensated cirrhosis do not show symptoms, while life expectancy is around 9–12 years. A person can remain asymptomatic for years, although 5–7% of those with the condition will develop symptoms every year.

Decompensated cirrhosis: People with decompensated cirrhosis already experience symptoms and complications. Their life expectancy is greatly reduced than those with compensated cirrhosis, while experts recommend referral for a possible liver transplant in these cases.

Physicians use diagnostic tests and scoring to determine a person’s stage of cirrhosis, which will help project their life expectancy. The Child-Turcotte-Pugh (CTP) system awards points based on whether an individual has:

  • an abnormal build-up of fluid in the abdomen, and how it responds to treatment
  • dysfunction in the brain
  • normal levels of albumin, a protein made by the liver
  • high levels of bilirubin, which could mean the liver is not working properly
  • normal blood clotting time, or international normalized ratio (INR)

With the CTP system, a person’s score increases according to the number and severity of their symptoms. Based on these scores, the system assigns people into different classes:

  • Class A: 5–6 points
  • Class B: 7–9 points
  • Class C: 10–15 points

Healthcare professionals will project the life expectancy of people with cirrhosis using CTP scores in the following chart:

CTP class3-month survival rate1-year survival rate2-year survival rate
Class A95. 7%95%90%
Class B88.8%80%70%
Class C59.9%45%38%

Physicians use the Model for End-Stage Liver Disease (MELD) to estimate the life expectancy for people with cirrhosis, setting priorities for liver transplants. Experts base MELD scores by measuring an individual’s:

  • bilirubin
  • INR
  • creatinine, which can indicate kidney damage

The higher an individual’s MELD score, the greater their risk of mortality, as shown by the chart below:

MELD scoreRisk of mortality
Less than 91.9%
10–196.0%
20–2919.6%
30–3952.6%
More than 4071.3%

Following an effective treatment plan, which could slow or stop damage to the liver and manage complications, is the primary way that people with cirrhosis can increase their life expectancy.

Treating the cause of the cirrhosis is also crucial. Even though not all occurrences are due to alcohol abuse, people with this condition can benefit from avoiding alcohol completely, as experts recommend. Antiviral drugs can prevent additional liver damage due to viral hepatitis.

People with cirrhosis need to regularly see their medical team to review how their condition is progressing. This also allows for early intervention and treatment of any complications that may arise. Medications and procedures to treat cirrhosis symptoms include:

  • diuretics to reduce excess fluid
  • laxatives to help rid the system of toxins
  • beta-blockers, to reduce portal hypertension
  • using hardening agents to stop bleeding
  • a shunt to reduce pressure
  • liver transplant

According to the VA, although cirrhosis is progressive, some people with the condition can move from decompensated, or symptomatic, back to the asymptomatic stage. This is a challenging process, although one of the critical steps is avoiding alcohol of any kind.

To prevent progressing from the asymptomatic to the symptomatic stage, people can make the following lifestyle changes:

  • exercising regularly
  • keeping to a moderate weight
  • getting treatment for conditions that might have caused cirrhosis, such as hepatitis C or B
  • getting regular check-ups and prompt treatment for complications
  • quitting smoking

Of people who develop cirrhosis, 20–60% also develop malnutrition, additional complications, longer hospital stays, and a reduced life expectancy.

This means eating a healthful diet is crucial for those with this condition. Cirrhosis itself can affect diet and metabolism, so people should try:

  • consuming a low-salt diet
  • limiting fluid intake
  • consuming smaller, more frequent meals
  • eating plenty of protein
  • taking zinc supplements
  • avoiding too much vitamin A and D
  • avoiding taking vitamin C, if iron levels are high

Cirrhosis is a severe condition, causing scarring and permanent damage to the liver. It can be fatal.

For people with cirrhosis, there is a close link between life expectancy and the number of symptoms and complications they experience.

Physicians use CTP and MELD scores for guidance in referrals for liver transplants.

Although this condition greatly reduces life expectancy, there several ways, such as certain dietary changes and avoiding alcohol, that may help.

The prognosis and outcome of alcoholic liver disease

Review

. 1994;2:335-43.

M Y Morgan 
1

Affiliations

Affiliation

  • 1 University Department of Medicine, Royal Free Hospital and School of Medicine, London, UK.

  • PMID:

    8974353

Review

M Y Morgan.

Alcohol Alcohol Suppl.

1994.

. 1994;2:335-43.

Author

M Y Morgan 
1

Affiliation

  • 1 University Department of Medicine, Royal Free Hospital and School of Medicine, London, UK.

  • PMID:

    8974353

Abstract

Alcoholic liver disease evolves from fatty change through alcoholic hepatitis to alcoholic cirrhosis. Its development is associated with an excess mortality both in relation to the presence of liver disease and to other complications of alcohol abuse. In the majority of patients fatty liver is a benign lesion which will reverse completely following abstinence from alcohol. Continued drinking is associated with the eventual development of cirrhosis in approximately 20% of individuals. Survival rates of 70% are reported both at 2 years and at 10 years. Alcoholic hepatitis is a precirrhotic lesion; progression to cirrhosis is observed more commonly in women, in individuals with severe disease and in those who continue to drink. Thirty-day mortality rates of less than 20% are observed in patients with mild to moderate disease but exceed 40% in individuals with severe liver injury. Corticosteroids may improve short term survival in a small subgroup of patients with severe alcoholic hepatitis. Survival rates of 55 to 60% are reported both at 2 years and at 10 years. Survival is significantly reduced in women and in the elderly and is adversely affected by the presence of severe liver injury, evolution to cirrhosis and continued drinking. Two-thirds of patients with alcoholic cirrhosis present with decompensated disease; 15% will develop hepatocellular carcinoma. Survival rates at 5 years vary from zero to 80%; 60 to 90% of individuals die of their liver disease. Survival is adversely affected by the presence of decompensated disease, superimposed alcoholic hepatitis, continued drinking and the development of hepatocellular carcinoma. The advent of hepatic transplantation, which has a 5-year survival rate in excess of 70%, will influence these survival figures.

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Publication types

MeSH terms

Liver failure – causes, stages, symptoms, signs, diagnosis, treatment

Causes

Classification

Symptoms

Diagnosis

Treatment

Prognosis and prevention

Liver failure is a disease that develops in a person when the functioning of the liver is impaired. It can have acute and chronic forms. The syndrome of liver failure manifests itself in the form of a metabolic disorder, intoxication, and disturbances in the functioning of the brain. As a result, everything ends with a hepatic coma, which is the last stage in the development of pathology.

Liver failure in women or men develops as a result of violations of the structure of the parenchyma of the organ. It can be dystrophic, fibrous or necrotic. Against the background of these disorders, the detoxification ability of the liver is sharply reduced, due to which decay products accumulate in the body and the work of other organs is disrupted. Mortality even with treatment reaches 80%. Liver failure according to the ICD has the code K72.

Causes and triggers

Viral inflammatory diseases, especially hepatitis A and B, are considered the main causes of liver failure. Against their background, pathology usually occurs and progresses in patients aged 40 years and older, especially in the presence of such bad habits as drug addiction or alcoholism.

Less likely to provoke the disease can:

  • Epstein-Barr virus;
  • simple herpes;
  • adenovirus;
  • cytomegalovirus.

In second place in frequency is the uncontrolled use of drugs and exposure to toxins. Often provokes acute liver failure excessive use of paracetamol, analgin, NSAIDs, sedatives, diuretics. Very strong toxins that have an adverse effect on the liver are pale toadstool poison, chemical compounds, aspergillus mycotoxin.

Other pathologies of the human body can also provoke the disease: heart failure, vein occlusive disease, profuse bleeding. It is noted that people with lymphomas, cancer metastases to the lungs or pancreatic cancer are often also diagnosed with chronic liver failure.

More rare triggers are:

  • blunt abdominal trauma;
  • galactosemia;
  • autoimmune hepatitis;
  • hypokalemia;
  • bleeding of a gastric or intestinal nature;
  • excessive consumption of protein foods.

However, in 30% of all cases, it is not possible to identify the cause or suggestive factor that caused the disease.

Classification

The course of pathology is acute and chronic. AKI is noted in the first 2 months of exposure to a provoking factor. CRF is caused by progressive chronic diseases and develops in the case of cirrhosis, the presence of tumors, fibrosis and other pathological conditions.

The classification of liver failure distinguishes endogenous, exogenous and mixed forms. In the first case, up to 80% of all hepatocytes die as a result of viral diseases and toxic damage to the organ. In the second case, the disease develops as a result of impaired blood flow in the liver. Mixed is the result of the influence of the first and second factors.

Liver failure occurs in four stages, which follow one after another, namely:

  1. Initial, or compensated.
  2. Expressed or decompensated.
  3. Terminal, or dystrophic.
  4. Hepatic coma.

The degree of liver failure is determined by laboratory parameters. The main role here is played by the amount of bilirubin in the blood. In the first degree, the amount of bilirubin is in the range from 0 to 100 micromoles per liter of blood. With the second, the figure increases from 100 to 200, and with the third it exceeds 200 µmol / l.

Symptoms

Symptoms of liver failure will depend on the diagnosed stage of the disease. At the very beginning, the patient has a decrease or perversion of appetite, weakness does not go away even after a long rest, nausea is constantly present, and sometimes vomiting is observed that does not bring relief.

There is a noticeable decrease in working capacity, there is an aversion to certain types of dishes, emotional disorders are noted. It is impossible to independently make an accurate diagnosis according to such signs of liver failure. Many in the first stage of the disease do not go to the doctor, because they believe that they have symptoms of food poisoning or chronic fatigue.

During the second stage of the disease, jaundice appears, which becomes more noticeable every day. Hemorrhagic diathesis develops, signs of ascites appear: in a person, the stomach begins to increase in size, which is in no way connected with overeating, but is the result of accumulation of fluid in the abdominal cavity.

Weakness is felt throughout the day, working capacity is almost zero, dyspeptic disorders appear, and edema on the body is of a hypoproteinemic nature.

The third stage is considered the most difficult downstream. The patient begins cachexia, all metabolic processes are disturbed, dystrophic changes affect not only the liver, but also other organs. The disease ends with hepatic coma.

Diagnostics

A gastroenterologist is engaged in the diagnosis, therapy and prevention of liver failure, but if possible, the patient is referred to a narrower specialist – a hepatologist.

Before making an accurate diagnosis, the doctor collects an anamnesis: alcohol abuse, viral hepatitis in the past, metabolic diseases, the presence of chronic liver pathologies or tumors, long-term use of high doses of toxic drugs.

Blood analysis reveals anemia, elevated leukocyte count, decreased PTI, and thrombocytopenia. It is important to track the readings of biochemical tests in dynamics: an increased level of bilirubin, protein, and creatinine helps to make an accurate diagnosis.

Ultrasound helps to determine the prevalence of the process and the stage of the disease. Hepatoscintigraphy helps to determine the phenomena of diffuse liver damage, to detect the presence of hepatitis, cirrhosis or fatty hepatosis. If necessary, the examination is supplemented by an MRI or CT scan.

Treatment

Help for people with liver failure is provided in a hospital setting. Be sure to prescribe a diet with the complete exclusion of protein foods. If necessary, nutrition is carried out through a tube or parenterally.

5% glucose is administered intravenously in large quantities, as well as vitamins, cocarboxylase, panangin, essentiale, lipoic acid. To reduce the absorption of toxins in the intestines, cleansing enemas or a course of laxatives are used. To suppress the processes of decay, antibiotics are prescribed.

The treatment of liver failure also includes the administration of prednisolone or other drugs from the group of corticosteroids. The use of oxygen inhalation or hyperbaric oxygenation has proven itself well.

According to clinical recommendations, people with liver failure should receive courses of hemodialysis, hemosorption, plasmapheresis, and ultraviolet blood for blood purification.

Prognosis and prevention

With proper and intensive treatment, the disease in the first and second stages of its development is completely amenable to prescribed therapy. In the case of the development of hepatic encephalopathy, the terminal stage almost always follows, which quickly leads to hepatic coma. With a deep coma without adequate treatment, a fatal outcome is inevitable.

As a preventive measure, it is recommended to give up bad habits, avoid drug overdose and self-medication, treat all liver diseases in a timely manner, and prevent hepatotoxic effects of harmful substances.

The author of the article:

Nikitina Olga Ivanovna

therapist, gastroenterologist, KMN

work experience 5 years

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