Highlights & Basics
- Cirrhosis is the pathologic end-stage of any chronic liver disease and most commonly results from chronic hepatitis B and C, alcohol-related liver disease, and metabolic dysfunction-associated steatotic liver disease.
- The main complications of cirrhosis are related to the development of liver insufficiency and portal hypertension and include ascites, variceal hemorrhage, jaundice, portosystemic encephalopathy, acute kidney injury and hepatopulmonary syndromes, and the development of hepatocellular carcinoma.
- Once a patient with cirrhosis develops signs of decompensation, survival is significantly impaired.
- Management of cirrhosis includes treating underlying liver disease, avoiding superimposed injury, and managing complications. Timely referral for liver transplantation may be the only curative treatment option for patients with decompensated cirrhosis.
- Chronic liver disease and cirrhosis are significant causes of premature mortality.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Laparoscopic view of a cirrhotic liver
Icterus or jaundice
Liver palms erythema of adult alcoholic
Preoperative view of a small finger flexion contracture
Caput medusa: dilated superficial (superior and inferior) epigastric veins radiating from a central large venous varix
Ascites. View of the abdomen of a female patient with alcoholic liver disease and cirrhosis, showing swelling due to ascites (accumulation of fluid in the peritoneal cavity), jaundice (yellowing of the skin), and bruising
Child-Pugh-Turcotte scoring system
Esophageal varices in a patient with portal hypertension
Citations
Kaplan DE, Ripoll C, Thiele M, et al. AASLD practice guidance on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology. 2024 May 1;79(5):1180-211.[Abstract][Full Text]
de Franchis R, Bosch J, Garcia-Tsao G, et al. Baveno VII: renewing consensus in portal hypertension. J Hepatol. 2022 Apr;76(4):959-74.[Abstract][Full Text]
European Association for the Study of the Liver. EASL clinical practice guidelines on non-invasive tests for evaluation of liver disease severity and prognosis: 2021 update. J Hepatol. 2021 Sep;75(3):659-89.[Abstract][Full Text]
European Association for the Study of the Liver. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018 Aug;69(2):406-60.[Abstract][Full Text]
Rogal SS, Hansen L, Patel A, et al. AASLD practice guidance: palliative care and symptom-based management in decompensated cirrhosis. Hepatology. 2022 Sep;76(3):819-53.[Abstract][Full Text]
European Association for the Study of the Liver. EASL clinical practice guidelines on the management of hepatic encephalopathy. J Hepatol. 2022 Sep;77(3):807-24.[Abstract][Full Text]
1. Anthony PP, Ishak KG, Nayak NC, et al. The morphology of cirrhosis: definition, nomenclature, and classification. Bull World Health Organ. 1977;55(4):521-40.[Abstract]
2. Kaplan DE, Ripoll C, Thiele M, et al. AASLD practice guidance on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology. 2024 May 1;79(5):1180-211.[Abstract][Full Text]
3. Tapper EB, Parikh ND. Diagnosis and management of cirrhosis and its complications: a review. JAMA. 2023 May 9;329(18):1589-602.[Abstract][Full Text]
4. Wu XN, Xue F, Zhang N, et al. Global burden of liver cirrhosis and other chronic liver diseases caused by specific etiologies from 1990 to 2019. BMC Public Health. 2024 Feb 3;24(1):363.[Abstract][Full Text]
5. Huang DQ, Terrault NA, Tacke F, et al. Global epidemiology of cirrhosis - aetiology, trends and predictions. Nat Rev Gastroenterol Hepatol. 2023 Jun;20(6):388-98.[Abstract][Full Text]
6. Moon AM, Singal AG, Tapper EB. Contemporary epidemiology of chronic liver disease and cirrhosis. Clin Gastroenterol Hepatol. 2020 Nov;18(12):2650-66.[Abstract][Full Text]
7. GBD 2017 Cirrhosis Collaborators. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2020 Mar;5(3):245-66.[Abstract][Full Text]
8. Hirode G, Saab S, Wong RJ. Trends in the burden of chronic liver disease among hospitalized US adults. JAMA Netw Open. 2020 Apr 1;3(4):e201997.[Abstract][Full Text]
9. Office for Health Improvement and Disparities. Liver disease: applying All Our Health. May 2022 [internet publication].[Full Text]
10. Lan Y, Wang H, Weng H, et al. The burden of liver cirrhosis and underlying etiologies: results from the Global Burden of Disease Study 2019. Hepatol Commun. 2023 Feb 1;7(2):e0026.[Abstract][Full Text]
11. Davis GL, Roberts WL. The healthcare burden imposed by liver disease in aging Baby Boomers. Curr Gastroenterol Rep. 2010 Feb;12(1):1-6.[Abstract]
12. Harris R, Card TR, Delahooke T, et al. Obesity is the most common risk factor for chronic liver disease: results from a risk stratification pathway using transient elastography. Am J Gastroenterol. 2019 Nov;114(11):1744-52.[Abstract]
13. Adam R, Karam V, Delvart V, et al. Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR). J Hepatol. 2012 Sep;57(3):675-88.[Abstract][Full Text]
14. Pimpin L, Cortez-Pinto H, Negro F, et al. Burden of liver disease in Europe: epidemiology and analysis of risk factors to identify prevention policies. J Hepatol. 2018 Sep;69(3):718-35.[Abstract]
15. Lee UE, Friedman SL. Mechanisms of hepatic fibrogenesis. Best Pract Res Clin Gastroenterol. 2011 Apr;25(2):195-206.[Abstract][Full Text]
16. Zhang CY, Yuan WG, He P, et al. Liver fibrosis and hepatic stellate cells: etiology, pathological hallmarks and therapeutic targets. World J Gastroenterol. 2016 Dec 28;22(48):10512-22.[Abstract][Full Text]
17. Parola M, Pinzani M. Liver fibrosis: pathophysiology, pathogenetic targets and clinical issues. Mol Aspects Med. 2019 Feb;65:37-55.[Abstract]
18. Haj M, Rockey DC. Ammonia levels do not guide clinical management of patients with hepatic encephalopathy caused by cirrhosis. Am J Gastroenterol. 2020 May;115(5):723-8.[Abstract]
19. Lai JC, Rahimi RS, Verna EC, et al. Frailty associated with waitlist mortality independent of ascites and hepatic encephalopathy in a multicenter study. Gastroenterology. 2019 May;156(6):1675-82.[Abstract]
20. Chang KV, Chen JD, Wu WT, et al. Association of loss of muscle mass with mortality in liver cirrhosis without or before liver transplantation: A systematic review and meta-analysis. Medicine (Baltimore). 2019 Mar;98(9):e14373.[Abstract][Full Text]
21. Dasarathy S. Cause and management of muscle wasting in chronic liver disease. Curr Opin Gastroenterol. 2016 May;32(3):159-65.[Abstract][Full Text]
22. Tantai X, Liu Y, Yeo YH, et al. Effect of sarcopenia on survival in patients with cirrhosis: a meta-analysis. J Hepatol. 2022 Mar;76(3):588-99.[Abstract][Full Text]
23. Mazeaud S, Zupo R, Couret A, et al. Prevalence of sarcopenia in liver cirrhosis: a systematic review and meta-analysis. Clin Transl Gastroenterol. 2023 Jul 1;14(7):e00584.[Abstract][Full Text]
24. Tuo S, Yeo YH, Chang R, et al. Prevalence of and associated factors for sarcopenia in patients with liver cirrhosis: a systematic review and meta-analysis. Clin Nutr. 2024 Jan;43(1):84-94.[Abstract]
25. Piano S, Bunchorntavakul C, Marciano S, et al. Infections in cirrhosis. Lancet Gastroenterol Hepatol. 2024 Aug;9(8):745-57.[Abstract]
26. Alvarez MA, Cirera I, Solà R, et al. Long-term clinical course of decompensated alcoholic cirrhosis: a prospective study of 165 patients. J Clin Gastroenterol. 2011 Nov-Dec;45(10):906-11.[Abstract]
27. D'Ambrosio R, Aghemo A, Rumi MG, et al. A morphometric and immunohistochemical study to assess the benefit of a sustained virological response in hepatitis C virus patients with cirrhosis. Hepatology. 2012 Aug;56(2):532-43.[Abstract]
28. Pellicoro A, Aucott RL, Ramachandran P, et al. Elastin accumulation is regulated at the level of degradation by macrophage metalloelastase (MMP-12) during experimental liver fibrosis. Hepatology. 2012 Jun;55(6):1965-75.[Abstract]
29. Roerecke M, Vafaei A, Hasan OSM, et al. Alcohol consumption and risk of liver cirrhosis: a systematic review and meta-analysis. Am J Gastroenterol. 2019 Oct;114(10):1574-86.[Abstract][Full Text]
30. World Health Organization. Hepatitis B. Apr 2024 [internet publication].[Full Text]
31. World Health Organization. Hepatitis C. Apr 2024 [internet publication].[Full Text]
32. Centers for Disease Control and Prevention. Viral hepatitis: global viral hepatitis: millions of people are affected. Jul 2021 [internet publication].[Full Text]
33. Iwamura K. Clinicopathological aspects of liver diseases associated with early history of tattooing. Tokai J Exp Clin Med. 1988 Dec;13(4-5):191-218.[Abstract]
34. Walter KL. What is cirrhosis? JAMA. 2023 Jul 25;330(4):386.[Abstract][Full Text]
35. Udell JA, Wang CS, Tinmouth J, et al. Does this patient with liver disease have cirrhosis? JAMA. 2012 Feb 22;307(8):832-42.[Abstract]
36. Ortega-Alonso A, Andrade RJ. Chronic liver injury induced by drugs and toxins. J Dig Dis. 2018 Sep;19(9):514-21.[Abstract]
37. Cheema HI, Haselow D, Dranoff JA. Review of existing evidence demonstrates that methotrexate does not cause liver fibrosis. J Investig Med. 2022 Oct;70(7):1452-60.[Abstract]
38. Andrade RJ, Medina-Caliz I, Gonzalez-Jimenez A, et al. Hepatic damage by natural remedies. Semin Liver Dis. 2018 Feb;38(1):21-40.[Abstract][Full Text]
39. Hassan MM, Spitz MR, Thomas MB, et al. The association of family history of liver cancer with hepatocellular carcinoma: a case-control study in the United States. J Hepatol. 2009 Feb;50(2):334-41.[Abstract][Full Text]
40. Liu Y, Zhao Y, Gao X, et al. Recognizing skin conditions in patients with cirrhosis: a narrative review. Ann Med. 2022 Dec;54(1):3017-29.[Abstract][Full Text]
41. Ahmed Z, Ahmed U, Walayat S, et al. Liver function tests in identifying patients with liver disease. Clin Exp Gastroenterol. 2018 Aug 23;11:301-7.[Abstract][Full Text]
42. Sullivan MK, Daher HB, Rockey DC. Normal or near normal aminotransferase levels in patients with alcoholic cirrhosis. Am J Med Sci. 2022 Jun;363(6):484-9.[Abstract]
43. Giannini E, Risso D, Botta F, et al. Validity and clinical utility of the aspartate aminotransferase-alanine aminotransferase ratio in assessing disease severity and prognosis in patients with hepatitis C virus-related chronic liver disease. Arch Intern Med. 2003 Jan 27;163(2):218-24.[Abstract][Full Text]
44. Cai JJ, Wang K, Jiang HQ, et al. Characteristics, risk factors, and adverse outcomes of hyperkalemia in acute-on-chronic liver failure patients. Biomed Res Int. 2019 Feb 27;2019:6025726.[Abstract][Full Text]
45. Wallerstedt S, Simrén M, Wahlin S, et al. Moderate hyperkalemia in hospitalized patients with cirrhotic ascites indicates a poor prognosis. Scand J Gastroenterol. 2013 Mar;48(3):358-65.[Abstract][Full Text]
46. O'Shea RS, Davitkov P, Ko CW, et al. AGA clinical practice guideline on the management of coagulation disorders in patients with cirrhosis. Gastroenterology. 2021 Nov;161(5):1615-27.[Abstract][Full Text]
47. Afdhal N, McHutchison J, Brown R, et al. Thrombocytopenia associated with chronic liver disease. J Hepatol. 2008 Jun;48(6):1000-7.[Abstract][Full Text]
48. Kwo PY, Cohen SM, Lim JK. ACG clinical guideline: evaluation of abnormal liver chemistries. Am J Gastroenterol. 2017 Jan;112(1):18-35.[Abstract][Full Text]
49. European Association for the Study of the Liver. EASL clinical practice guidelines on haemochromatosis. J Hepatol. 2022 Aug;77(2):479-502.[Abstract][Full Text]
50. Liu WT, Jing YY, Han ZP, et al. The injured liver induces hyperimmunoglobulinemia by failing to dispose of antigens and endotoxins in the portal system. PLoS One. 2015 Mar 31;10(3):e0122739.[Abstract][Full Text]
51. American Thoracic Society; European Respiratory Society. American Thoracic Society/European Respiratory Society statement: standards for the diagnosis and management of individuals with alpha-1 antitrypsin deficiency. Am J Respir Crit Care Med. 2003 Oct 1;168(7):818-900.[Abstract][Full Text]
52. Zhang J, Chen G, Zhang P, et al. The threshold of alpha-fetoprotein (AFP) for the diagnosis of hepatocellular carcinoma: a systematic review and meta-analysis. PLoS One. 2020 Feb 13;15(2):e0228857.[Abstract][Full Text]
53. de Franchis R, Bosch J, Garcia-Tsao G, et al. Baveno VII: renewing consensus in portal hypertension. J Hepatol. 2022 Apr;76(4):959-74.[Abstract][Full Text]
54. Wickremeratne T, Turner S, O'Beirne J. Systematic review with meta-analysis: ultra-thin gastroscopy compared to conventional gastroscopy for the diagnosis of oesophageal varices in people with cirrhosis. Aliment Pharmacol Ther. 2019 Jun;49(12):1464-73.[Abstract]
55. Vadera S, Yong CWK, Gluud LL, et al. Band ligation versus no intervention for primary prevention of upper gastrointestinal bleeding in adults with cirrhosis and oesophageal varices. Cochrane Database Syst Rev. 2019 Jun 20;6:CD012673.[Abstract][Full Text]
56. Roccarina D, Best LM, Freeman SC, et al. Primary prevention of variceal bleeding in people with oesophageal varices due to liver cirrhosis: a network meta-analysis. Cochrane Database Syst Rev. 2021 Apr 6;4(4):CD013121.[Abstract][Full Text]
57. Villanueva C, Sapena V, Lo GH, et al. Improving primary prophylaxis of variceal bleeding by adapting therapy to the clinical stage of cirrhosis. A competing-risk meta-analysis of individual participant data. Aliment Pharmacol Ther. 2024 Feb;59(3):306-21.[Abstract]
58. Deng H, Qi X, Guo X. Computed tomography for the diagnosis of varices in liver cirrhosis: a systematic review and meta-analysis of observational studies. Postgrad Med. 2017 Apr;129(3):318-28.[Abstract]
59. Xiao H, Shi M, Xie Y, et al. Comparison of diagnostic accuracy of magnetic resonance elastography and Fibroscan for detecting liver fibrosis in chronic hepatitis B patients: a systematic review and meta-analysis. PLoS One. 2017 Nov 6;12(11):e0186660.[Abstract][Full Text]
60. European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018 Jul;69(1):182-236.[Abstract]
61. West J, Card TR. Reduced mortality rates following elective percutaneous liver biopsies. Gastroenterology. 2010 Oct;139(4):1230-7.[Abstract]
62. Child CG, Turcotte JG. Surgery and portal hypertension. Major Probl Clin Surg. 1964;1:1-85.[Abstract]
63. Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973 Aug;60(8):646-9.[Abstract]
64. Jepsen P, Vilstrup H, Lash TL. Development and validation of a comorbidity scoring system for patients with cirrhosis. Gastroenterology. 2014 Jan;146(1):147-56; quiz e15-6.[Abstract]
65. Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008 Sep 4;359(10):1018-26.[Abstract][Full Text]
66. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001 Feb;33(2):464-70.[Abstract]
67. Sterling RK, Duarte-Rojo A, Patel K, et al. AASLD practice guideline on imaging-based noninvasive liver disease assessment of hepatic fibrosis and steatosis. Hepatology. 2024 Mar 15 [Epub ahead of print].[Abstract][Full Text]
68. Barr RG, Wilson SR, Rubens D, et al. Update to the Society of Radiologists in Ultrasound liver elastography consensus statement. Radiology. 2020 Aug;296(2):263-74.[Abstract][Full Text]
69. Talwalkar JA, Kurtz DM, Schoenleber SJ, et al. Ultrasound-based transient elastography for the detection of hepatic fibrosis: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2007 Oct;5(10):1214-20.[Abstract]
70. Friedrich-Rust M, Ong MF, Martens S, et al. Performance of transient elastography for the staging of liver fibrosis: a meta-analysis. Gastroenterology. 2008 Apr;134(4):960-74.[Abstract]
71. Stebbing J, Farouk L, Panos G, et al. A meta-analysis of transient elastography for the detection of hepatic fibrosis. J Clin Gastroenterol. 2010 Mar;44(3):214-9.[Abstract]
72. Chon YE, Choi EH, Song KJ, et al. Performance of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B: a meta-analysis. PLoS One. 2012;7(9):e44930.[Abstract][Full Text]
73. Takuma Y, Nouso K, Morimoto Y, et al. Measurement of spleen stiffness by acoustic radiation force impulse imaging identifies cirrhotic patients with esophageal varices. Gastroenterology. 2013 Jan;144(1):92-101.e2.[Abstract][Full Text]
74. Cassinotto C, Boursier J, de Lédinghen V, et al. Liver stiffness in nonalcoholic fatty liver disease: a comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology. 2016 Jun;63(6):1817-27.[Abstract]
75. Hu X, Qiu L, Liu D, et al. Acoustic radiation force impulse (ARFI) elastography for non‑invasive evaluation of hepatic fibrosis in chronic hepatitis B and C patients: a systematic review and meta-analysis. Med Ultrason. 2017 Jan 31;19(1):23-31.[Abstract][Full Text]
76. Adebajo CO, Talwalkar JA, Poterucha JJ, et al. Ultrasound-based transient elastography for the detection of hepatic fibrosis in patients with recurrent hepatitis C virus after liver transplantation: a systematic review and meta-analysis. Liver Transpl. 2012 Mar;18(3):323-31.[Abstract][Full Text]
77. European Association for the Study of the Liver. EASL clinical practice guidelines on non-invasive tests for evaluation of liver disease severity and prognosis: 2021 update. J Hepatol. 2021 Sep;75(3):659-89.[Abstract][Full Text]
78. Yang D, Li D, Li J, et al. Systematic review: the diagnostic efficacy of gadoxetic acid-enhanced MRI for liver fibrosis staging. Eur J Radiol. 2020 Apr;125:108857.[Abstract]
79. Xu X, Jin J, Liu Y. Performance of FibroScan in grading steatosis and fibrosis in patients with nonalcoholic fatty liver disease: a meta-analysis. Arab J Gastroenterol. 2023 Nov;24(4):189-97.[Abstract]
80. National Institute for Health and Care Excellence. FibroScan for assessing liver fibrosis and cirrhosis outside secondary and specialist care. Jun 2023 [internet publication].[Full Text]
81. Sterling RK, Patel K, Duarte-Rojo A, et al. AASLD practice guideline on blood-based noninvasive liver disease assessment of hepatic fibrosis and steatosis. Hepatology. 2024 Mar 15 [Epub ahead of print].[Abstract][Full Text]
82. European Association for the Study of the Liver. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol. 2017 Aug;67(2):370-98.[Abstract][Full Text]
83. Sterling RK, Asrani SK, Levine D, et al. AASLD practice guideline on noninvasive liver disease assessment of portal hypertension. Hepatology. 2024 Mar 15 [Epub ahead of print].[Abstract][Full Text]
84. Thabut D, Weil D, Bouzbib C, et al. Non-invasive diagnosis and follow-up of portal hypertension. Clin Res Hepatol Gastroenterol. 2022 Oct;46(8):101767.[Abstract]
85. de Franchis R, Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015 Sep;63(3):743-52.[Abstract][Full Text]
86. European Association for the Study of the Liver. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018 Aug;69(2):406-60.[Abstract][Full Text]
87. Angeli P, Gines P, Wong F, et al. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. Gut. 2015 Apr;64(4):531-7.[Abstract][Full Text]
88. Flamm SL, Wong F, Ahn J, et al. AGA clinical practice update on the evaluation and management of acute kidney injury in patients with cirrhosis: expert review. Clin Gastroenterol Hepatol. 2022 Dec;20(12):2707-16.[Abstract][Full Text]
89. Wong F. Acute kidney injury in liver cirrhosis: new definition and application. Clin Mol Hepatol. 2016 Dec;22(4):415-22.[Abstract][Full Text]
90. Karvellas CJ, Bajaj JS, Kamath PS, et al. AASLD practice guidance on acute-on-chronic liver failure and the management of critically ill patients with cirrhosis. Hepatology. 2024 Jun 1;79(6):1463-502.[Abstract][Full Text]
91. American College of Radiology. ACR Appropriateness Criteria® Abnormal liver function tests. 2023 [internet publication].[Full Text]
92. Bajaj JS, O'Leary JG, Lai JC, et al. Acute-on-chronic liver failure clinical guidelines. Am J Gastroenterol. 2022 Feb 1;117(2):225-52.[Abstract][Full Text]
93. Crabb DW, Im GY, Szabo G, et al. Diagnosis and treatment of alcohol-associated liver diseases: 2019 practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2020 Jan;71(1):306-33.[Abstract][Full Text]
94. Lim JK, Flamm SL, Singh S, et al. American Gastroenterological Association Institute guideline on the role of elastography in the evaluation of liver fibrosis. Gastroenterology. 2017 May;152(6):1536-43.[Abstract][Full Text]
95. European Association for the Study of the Liver. European Association for the Study of the Liver. EASL clinical practice guidelines on acute-on-chronic liver failure. J Hepatol. 2023 Aug;79(2):461-91.[Abstract][Full Text]
96. European Association for the Study of the Liver. EASL clinical practice guidelines: management of alcohol-related liver disease. J Hepatol. 2018 Jul;69(1):154-81.[Abstract][Full Text]
97. National Institute for Health and Care Excellence. Liver disease. June 2017 [internet publication].[Full Text]
98. Newsome PN, Cramb R, Davison SM, et al. Guidelines on the management of abnormal liver blood tests. Gut. 2018 Jan;67(1):6-19.[Abstract][Full Text]
99. Perumpail BJ, Li AA, Cholankeril G, et al. Optimizing the nutritional support of adult patients in the setting of cirrhosis. Nutrients. 2017 Oct 13;9(10):E1114.[Abstract][Full Text]
100. Yew KC, Tan QR, Lim PC, et al. Assessing the impact of direct-acting antivirals on hepatitis C complications: a systematic review and meta-analysis. Naunyn Schmiedebergs Arch Pharmacol. 2024 Mar;397(3):1421-31.[Abstract]
101. American Association for the Study of Liver Diseases; Infectious Diseases Society of America. Hepatitis C guidance 2023 update: recommendations for testing, managing, and treating hepatitis C virus infection. Oct 2023 [internet publication].[Full Text]
102. Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018 Apr;67(4):1560-99.[Abstract][Full Text]
103. Biggins SW, Angeli P, Garcia-Tsao G, et al. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021;74(2):1014-48.[Abstract][Full Text]
104. European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53(3):397-417.[Abstract][Full Text]
105. Bernardi M, Caraceni P, Navickis RJ, et al. Albumin infusion in patients undergoing large-volume paracentesis: a meta-analysis of randomized trials. Hepatology. 2012 Apr;55(4):1172-81.[Abstract][Full Text]
106. Aithal GP, Palaniyappan N, China L, et al. Guidelines on the management of ascites in cirrhosis. Gut. 2021 Jan;70(1):9-29.[Abstract][Full Text]
107. Rimola A, Garcia-Tsao G, Navasa M, et al. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. J Hepatol. 2000 Jan;32(1):142-53.[Abstract]
108. Aithal GP, Palaniyappan N, China L, et al. Guidelines on the management of ascites in cirrhosis. Gut. 2021 Jan;70(1):9-29.[Abstract][Full Text]
109. Bernardi M, Caraceni P, Navickis RJ, et al. Albumin infusion in patients undergoing large-volume paracentesis: a meta-analysis of randomized trials. Hepatology. 2012 Apr;55(4):1172-81.[Abstract]
110. Benmassaoud A, Freeman SC, Roccarina D, et al. Treatment for ascites in adults with decompensated liver cirrhosis: a network meta-analysis. Cochrane Database Syst Rev. 2020 Jan 16;1:CD013123.[Abstract][Full Text]
111. D'Amico G, Luca A, Morabito A, et al. Uncovered transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis. Gastroenterology. 2005 Oct;129(4):1282-93.[Abstract]
112. Saab S, Nieto JM, Lewis SK, et al. TIPS versus paracentesis for cirrhotic patients with refractory ascites. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD004889.[Abstract][Full Text]
113. Albillos A, Bañares R, González M, et al. A meta-analysis of transjugular intrahepatic portosystemic shunt versus paracentesis for refractory ascites. J Hepatol. 2005 Dec;43(6):990-6.[Abstract]
114. Salerno F, Cammà C, Enea M, et al. Transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis of individual patient data. Gastroenterology. 2007 Sep;133(3):825-34.[Abstract][Full Text]
115. Chen RP, Zhu Ge XJ, Huang ZM, et al. Prophylactic use of transjugular intrahepatic portosystemic shunt aids in the treatment of refractory ascites: metaregression and trial sequential meta-analysis. J Clin Gastroenterol. 2014 Mar;48(3):290-9.[Abstract]
116. Bai M, Qi XS, Yang ZP, et al. TIPS improves liver transplantation-free survival in cirrhotic patients with refractory ascites: an updated meta-analysis. World J Gastroenterol. 2014 Mar 14;20(10):2704-14.[Abstract][Full Text]
117. Gazda J, Di Cola S, Lapenna L, et al. The impact of transjugular intrahepatic portosystemic shunt on nutrition in liver cirrhosis patients: a systematic review. Nutrients. 2023 Mar 27;15(7):1617.[Abstract][Full Text]
118. Larrue H, D'Amico G, Olivas P, et al. TIPS prevents further decompensation and improves survival in patients with cirrhosis and portal hypertension in an individual patient data meta-analysis. J Hepatol. 2023 Sep;79(3):692-703.[Abstract]
119. Lebrec D, Giuily N, Hadengue A, et al. Transjugular intrahepatic portosystemic shunts: comparison with paracentesis in patients with cirrhosis and refractory ascites: a randomized trial. French Group of Clinicians and a Group of Biologists. J Hepatol. 1996 Aug;25(2):135-44.[Abstract]
120. Macken L, Joshi D, Messenger J, et al. Palliative long-term abdominal drains in refractory ascites due to end-stage liver disease: a case series. Palliat Med. 2017 Jul;31(7):671-5.[Abstract]
121. Dahl E, Gluud LL, Kimer N, et al. Meta-analysis: the safety and efficacy of vaptans (tolvaptan, satavaptan and lixivaptan) in cirrhosis with ascites or hyponatraemia. Aliment Pharmacol Ther. 2012 Oct;36(7):619-26.[Abstract]
122. Yan L, Xie F, Lu J, et al. The treatment of vasopressin V2-receptor antagonists in cirrhosis patients with ascites: a meta-analysis of randomized controlled trials. BMC Gastroenterol. 2015 Jun 9;15:65.[Abstract][Full Text]
123. Tripathi D, Stanley AJ, Hayes PC, et al. U.K. guidelines on the management of variceal haemorrhage in cirrhotic patients. Gut. 2015 Nov;64(11):1680-704.[Abstract][Full Text]
124. Kerbert AJ, Chiang FW, van der Werf M, et al. Hemodynamic response to primary prophylactic therapy with nonselective beta-blockers is related to a reduction of first variceal bleeding risk in liver cirrhosis: a meta-analysis. Eur J Gastroenterol Hepatol. 2017 Apr;29(4):380-7.[Abstract]
125. Bossen L, Krag A, Vilstrup H, et al. Nonselective beta-blockers do not affect mortality in cirrhosis patients with ascites: Post Hoc analysis of three randomized controlled trials with 1198 patients. Hepatology. 2016 Jun;63(6):1968-76.[Abstract]
126. Sinha R, Lockman KA, Mallawaarachchi N, et al. Carvedilol use is associated with improved survival in patients with liver cirrhosis and ascites. J Hepatol. 2017 Jul;67(1):40-6.[Abstract]
127. Leithead JA, Rajoriya N, Tehami N, et al. Non-selective beta-blockers are associated with improved survival in patients with ascites listed for liver transplantation. Gut. 2015 Jul;64(7):1111-9.[Abstract]
128. Zacharias AP, Jeyaraj R, Hobolth L, et al. Carvedilol versus traditional, non-selective beta-blockers for adults with cirrhosis and gastroesophageal varices. Cochrane Database Syst Rev. 2018 Oct 29;10:CD011510.[Abstract][Full Text]
129. Gralnek IM, Camus Duboc M, Garcia-Pagan JC, et al. Endoscopic diagnosis and management of esophagogastric variceal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2022 Nov;54(11):1094-120.[Abstract]
130. Garcia-Pagán JC, Bosch J. Endoscopic band ligation in the treatment of portal hypertension. Nat Clin Pract Gastroenterol Hepatol. 2005 Nov;2(11):526-35.[Abstract]
131. Li L, Yu C, Li Y. Endoscopic band ligation versus pharmacological therapy for variceal bleeding in cirrhosis: a meta-analysis. Can J Gastroenterol. 2011 Mar;25(3):147-55.[Abstract][Full Text]
132. Yan K, Bridges JF, Augustin S, et al. Factors impacting physicians' decisions to prevent variceal hemorrhage. BMC Gastroenterol. 2015 May 2;15:55.[Abstract][Full Text]
133. Jing L, Zhang Q, Chang Z, et al. Nonsurgical secondary prophylaxis of esophageal variceal bleeding in cirrhotic patients: a systematic review and network meta-analysis. J Clin Gastroenterol. 2021 Feb 1;55(2):159-68.[Abstract]
134. D'Amico G, Pagliaro L, Bosch J. The treatment of portal hypertension: a meta-analytic review. Hepatology. 1995 Jul;22(1):332-54.[Abstract][Full Text]
135. Li Y, Guo Y, Wang X, et al. Association between sarcopenia and hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with cirrhosis: a systematic review and meta-analysis. Abdom Radiol (NY). 2024 Feb;49(2):575-85.[Abstract]
136. Vine LJ, Subhani M, Acevedo JG. Update on management of gastric varices. World J Hepatol. 2019 Mar 27;11(3):250-60.[Abstract][Full Text]
137. Odutayo A, Desborough MJ, Trivella M, et al. Restrictive versus liberal blood transfusion for gastrointestinal bleeding: a systematic review and meta-analysis of randomised controlled trials. Lancet Gastroenterol Hepatol. 2017 May;2(5):354-60.[Abstract]
138. Barkun AN, Almadi M, Kuipers EJ, et al. Management of nonvariceal upper gastrointestinal bleeding: guideline recommendations from the international consensus group. Ann Intern Med. 2019 Dec 3;171(11):805-22.[Abstract]
139. Garcia-Tsao G, Abraldes JG, Rich NE, et al. AGA clinical practice update on the use of vasoactive drugs and intravenous albumin in cirrhosis: expert review. Gastroenterology. 2024 Jan;166(1):202-10.[Abstract][Full Text]
140. Lau JYW, Yu Y, Tang RSY, et al. Timing of endoscopy for acute upper gastrointestinal bleeding. N Engl J Med. 2020 Apr 2;382(14):1299-308.[Abstract][Full Text]
141. Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila FI, et al. Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD002907.[Abstract][Full Text]
142. Fernández J, Ruiz del Arbol L, Gómez C, et al. Norfloxacin vs ceftriaxone in the prophylaxis of infections in patients with advanced cirrhosis and hemorrhage. Gastroenterology. 2006 Oct;131(4):1049-56.[Abstract][Full Text]
143. Tandon P, Abraldes JG, Keough A, et al. Risk of bacterial infection in patients with cirrhosis and acute variceal hemorrhage, based on Child-Pugh class, and effects of antibiotics. Clin Gastroenterol Hepatol. 2015 Jun;13(6):1189-96.[Abstract][Full Text]
144. Maiwall R, Jamwal KD, Bhardwaj A, et al. SX-Ella Stent Danis effectively controls refractory variceal bleed in patients with acute-on-chronic liver failure. Dig Dis Sci. 2018 Feb;63(2):493-501.[Abstract]
145. Lai JC, Tandon P, Bernal W, et al. Malnutrition, frailty, and sarcopenia in patients with cirrhosis: 2021 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021 Sep;74(3):1611-44.[Abstract][Full Text]
146. Sort P, Navasa M, Arroyo V, et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med. 1999 Aug 5;341(6):403-9.[Abstract][Full Text]
147. Leache L, Gutiérrez-Valencia M, Saiz LC, et al. Meta-analysis: efficacy and safety of albumin in the prevention and treatment of complications in patients with cirrhosis. Aliment Pharmacol Ther. 2023 Mar;57(6):620-34.[Abstract]
148. Loomba R, Wesley R, Bain A, et al. Role of fluoroquinolones in the primary prophylaxis of spontaneous bacterial peritonitis: meta-analysis. Clin Gastroenterol Hepatol. 2009 Apr;7(4):487-93.[Abstract]
149. Kamal F, Khan MA, Khan Z, et al. Rifaximin for the prevention of spontaneous bacterial peritonitis and hepatorenal syndrome in cirrhosis: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2017 Oct;29(10):1109-17.[Abstract]
150. Hwang SJ, Lee DH, Koh SJ, et al. Correlation between proton pump inhibitors and the complications of liver cirrhosis: a systematic review and meta-analysis. Turk J Gastroenterol. 2022 Jan;33(1):44-52.[Abstract][Full Text]
151. Iogna Prat L, Wilson P, Freeman SC, et al. Antibiotic treatment for spontaneous bacterial peritonitis in people with decompensated liver cirrhosis: a network meta-analysis. Cochrane Database Syst Rev. 2019 Sep 16;9:CD013120.[Abstract][Full Text]
152. Badillo R, Rockey DC. Hepatic hydrothorax: clinical features, management, and outcomes in 77 patients and review of the literature. Medicine (Baltimore). 2014 May;93(3):135-42.[Abstract][Full Text]
153. Baig MA, Majeed MB, Attar BM, et al. Efficacy and safety of indwelling pleural catheters in management of hepatic hydrothorax: a systematic review of literature. Cureus. 2018 Aug 6;10(8):e3110.[Abstract][Full Text]
154. Avula A, Acharya S, Anwar S, et al. Indwelling pleural catheter (IPC) for the management of hepatic hydrothorax: the known and the unknown. J Bronchology Interv Pulmonol. 2022 Jul 1;29(3):179-85.[Abstract]
155. Xiol X, Tremosa G, Castellote J, et al. Liver transplantation in patients with hepatic hydrothorax. Transpl Int. 2005 Jun;18(6):672-5.[Abstract][Full Text]
156. Jepsen P, Ott P, Andersen PK, et al. Clinical course of alcoholic liver cirrhosis: a Danish population-based cohort study. Hepatology. 2010 May;51(5):1675-82.[Abstract][Full Text]
157. Sharma BC, Sharma P, Agrawal A, et al. Secondary prophylaxis of hepatic encephalopathy: an open-label randomized controlled trial of lactulose versus placebo. Gastroenterology. 2009 Sep;137(3):885-91, 891.e1.[Abstract][Full Text]
158. Shi D, Zhou Z, Dai Y, et al. Proton pump inhibitor therapy and hepatic encephalopathy risk in cirrhotic patients: a systematic review with meta-analysis. Clin Drug Investig. 2019 Sep;39(9):847-56.[Abstract]
159. Tantai XX, Yang LB, Wei ZC, et al. Association of proton pump inhibitors with risk of hepatic encephalopathy in advanced liver disease: a meta-analysis. World J Gastroenterol. 2019 Jun 7;25(21):2683-98.[Abstract][Full Text]
160. Sharma BC, Sharma P, Lunia MK, et al. A randomized, double-blind, controlled trial comparing rifaximin plus lactulose with lactulose alone in treatment of overt hepatic encephalopathy. Am J Gastroenterol. 2013 Sep;108(9):1458-63.[Abstract]
161. Gluud LL, Vilstrup H, Morgan MY. Non-absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev. 2016 May 6;(5):CD003044.[Abstract][Full Text]
162. Dhiman RK, Thumburu KK, Verma N, et al. Comparative efficacy of treatment options for minimal hepatic encephalopathy: a systematic review and network meta-analysis. Clin Gastroenterol Hepatol. 2020 Apr;18(4):800-12.e25.[Abstract][Full Text]
163. Zacharias HD, Kamel F, Tan J, et al. Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev. 2023 Jul 19;7(7):CD011585.[Abstract][Full Text]
164. Ahmed Z, Hassan M, Arif SF, et al. Comparative efficacy of treatment options for the prevention of post-TIPS hepatic encephalopathy: a systematic review and network meta-analysis. J Gastrointestin Liver Dis. 2023 Apr 1;32(1):70-6.[Abstract][Full Text]
165. Nardelli S, Gioia S, Faccioli J, et al. Hepatic encephalopathy - recent advances in treatment and diagnosis. Expert Rev Gastroenterol Hepatol. 2023 Mar;17(3):225-35.[Abstract]
166. Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014 Aug;60(2):715-35.[Abstract]
167. Cavallin M, Kamath PS, Merli M, et al. Terlipressin plus albumin versus midodrine and octreotide plus albumin in the treatment of hepatorenal syndrome: a randomized trial. Hepatology. 2015 Aug;62(2):567-74.[Abstract][Full Text]
168. Wong F, Pappas SC, Curry MP, et al. Terlipressin plus albumin for the treatment of type 1 hepatorenal syndrome. N Engl J Med. 2021 Mar 4;384(9):818-28.[Abstract][Full Text]
169. Lim AKH, Crnobrnja L, Metlapalli M, et al. Observational study of the relative efficacy of insulin-glucose treatment for hyperkalaemia in patients with liver cirrhosis. BMJ Open. 2021 Oct 22;11(10):e051201.[Abstract][Full Text]
170. Rodríguez-Roisin R, Krowka MJ. Hepatopulmonary syndrome - a liver-induced lung vascular disorder. N Engl J Med. 2008 May 29;358(22):2378-87.[Abstract]
171. Grilo-Bensusan I, Pascasio-Acevedo JM. Hepatopulmonary syndrome: what we know and what we would like to know. World J Gastroenterol. 2016 Jul 7;22(25):5728-41.[Abstract][Full Text]
172. Sitbon O, Bosch J, Cottreel E, et al. Macitentan for the treatment of portopulmonary hypertension (PORTICO): a multicentre, randomised, double-blind, placebo-controlled, phase 4 trial. Lancet Respir Med. 2019 Jul;7(7):594-604.[Abstract]
173. Nanchal R, Subramanian R, Karvellas CJ, et al. Guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU: cardiovascular, endocrine, hematologic, pulmonary, and renal considerations. Crit Care Med. 2020 Mar;48(3):e173-91.[Abstract][Full Text]
174. Lucey MR, Furuya KN, Foley DP. Liver transplantation. N Engl J Med. 2023 Nov 16;389(20):1888-900.[Abstract]
175. United Network for Organ Sharing. Transplant trends. 2022 [internet publication].[Full Text]
176. Zhou D, Zhang D, Zeng C, et al. Impact of sarcopenia on the survival of patients undergoing liver transplantation for decompensated liver cirrhosis. J Cachexia Sarcopenia Muscle. 2023 Dec;14(6):2602-12.[Abstract][Full Text]
177. Ferreira AP, Machado MV. Impact of pretransplant frailty and sarcopenia on the post-transplant prognosis of patients with liver cirrhosis: a systematic review. Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1s suppl 1):e883-97.[Abstract]
178. Tandon P, Walling A, Patton H, et al. AGA clinical practice update on palliative care management in cirrhosis: expert review. Clin Gastroenterol Hepatol. 2021 Apr;19(4):646-56.[Abstract][Full Text]
179. Rogal SS, Hansen L, Patel A, et al. AASLD practice guidance: palliative care and symptom-based management in decompensated cirrhosis. Hepatology. 2022 Sep;76(3):819-53.[Abstract][Full Text]
180. Biggins SW, Angeli P, Garcia-Tsao G, et al. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021 Aug;74(2):1014-48.[Abstract][Full Text]
181. Borrello MT, Mann D. Chronic liver diseases: from development to novel pharmacological therapies - IUPHAR review 37. Br J Pharmacol. 2023 Nov;180(22):2880-97.[Abstract][Full Text]
182. Lebrec D, Thabut D, Oberti F, et al. Pentoxifylline does not decrease short-term mortality but does reduce complications in patients with advanced cirrhosis. Gastroenterology. 2010 May;138(5):1755-62.[Abstract]
183. Stine JG, Wang J, Cornella SL, et al. Treatment of type-1 hepatorenal syndrome with pentoxifylline: a randomized placebo controlled clinical trial. Ann Hepatol. 2018 Mar 1;17(2):300-6.[Abstract][Full Text]
184. An L, Wirth U, Koch D, et al. The role of gut-derived lipopolysaccharides and the intestinal barrier in fatty liver diseases. J Gastrointest Surg. 2022 Mar;26(3):671-83.[Abstract][Full Text]
185. Huang L, Yu Q, Peng H, et al. Alterations of gut microbiome and effects of probiotic therapy in patients with liver cirrhosis: a systematic review and meta-analysis. Medicine (Baltimore). 2022 Dec 23;101(51):e32335.[Abstract][Full Text]
186. Jiang H, Peng Y, Zhang W, et al. Gut microbiome-targeted therapies in liver cirrhosis: a protocol for systematic review and meta-analysis. Syst Rev. 2022 Aug 30;11(1):181.[Abstract][Full Text]
187. Zhang H, Gao J. Antibiotics and probiotics on hepatic venous pressure gradient in cirrhosis: a systematic review and a meta-analysis. PLoS One. 2022 Aug 30;17(8):e0273231.[Abstract][Full Text]
188. Jiang H, Xu N, Zhang W, et al. Do gut microbiome-targeted therapies improve liver function in cirrhotic patients? A systematic review and meta-analysis. J Gastroenterol Hepatol. 2023 Nov;38(11):1900-9.[Abstract]
189. Wang H, Yao W, Wang Y, et al. Meta-analysis on last ten years of clinical injection of bone marrow-derived and umbilical cord MSC to reverse cirrhosis or rescue patients with acute-on-chronic liver failure. Stem Cell Res Ther. 2023 Sep 23;14(1):267.[Abstract][Full Text]
190. Liu Y, Dong Y, Wu X, et al. The assessment of mesenchymal stem cells therapy in acute on chronic liver failure and chronic liver disease: a systematic review and meta-analysis of randomized controlled clinical trials. Stem Cell Res Ther. 2022 May 16;13(1):204.[Abstract][Full Text]
191. Lu W, Qu J, Yan L, et al. Efficacy and safety of mesenchymal stem cell therapy in liver cirrhosis: a systematic review and meta-analysis. Stem Cell Res Ther. 2023 Oct 20;14(1):301.[Abstract][Full Text]
192. Fontana RJ, Liou I, Reuben A, et al. AASLD practice guidance on drug, herbal, and dietary supplement-induced liver injury. Hepatology. 2023 Mar 1;77(3):1036-65.[Abstract][Full Text]
193. Squires RH, Ng V, Romero R, et al. Evaluation of the pediatric patient for liver transplantation: 2014 practice guideline by the American Association for the Study of Liver Diseases, American Society of Transplantation and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Hepatology. 2014 Jul;60(1):362-98.[Abstract][Full Text]
194. Martin P, DiMartini A, Feng S, et al; AASLD. Evaluation for liver transplantation in adults: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Hepatology. 2014 Mar;59(3):1144-65.[Abstract]
195. Mansour D, Masson S, Shawcross DL, et al. British Society of Gastroenterology best practice guidance: outpatient management of cirrhosis - part 1: compensated cirrhosis. Frontline Gastroenterol. 2023 Jul 28;14(6):453-61.[Abstract][Full Text]
196. Mansour D, Masson S, Corless L, et al. British Society of Gastroenterology best practice guidance: outpatient management of cirrhosis - part 2: decompensated cirrhosis. Frontline Gastroenterol. 2023 Jul 28;14(6):462-73.[Abstract][Full Text]
197. Mansour D, Masson S, Hammond J, et al. British Society of Gastroenterology best practice guidance: outpatient management of cirrhosis - part 3: special circumstances. Frontline Gastroenterol. 2023 Jul 28;14(6):474-82.[Abstract][Full Text]
198. European Association for the Study of the Liver. EASL clinical practice guidelines on the management of hepatic encephalopathy. J Hepatol. 2022 Sep;77(3):807-24.[Abstract][Full Text]
199. European Association for the Study of the Liver. EASL clinical practice guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis. J Hepatol. 2022 May;76(5):1151-84.[Abstract][Full Text]
200. European Association for the Study of the Liver. EASL clinical practice guidelines on nutrition in chronic liver disease. J Hepatol. 2019 Jan;70(1):172-93.[Abstract][Full Text]
201. D'Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol. 2006 Jan;44(1):217-31.[Abstract]
202. Pinter M, Trauner M, Peck-Radosavljevic M, et al. Cancer and liver cirrhosis: implications on prognosis and management. ESMO Open. 2016 Mar 17;1(2):e000042.[Abstract][Full Text]
203. Fix OK, Hameed B, Fontana RJ, et al. Clinical best practice advice for hepatology and liver transplant providers during the COVID-19 pandemic: AASLD Expert Panel Consensus Statement. Hepatology. 2020 Jul;72(1):287-304.[Abstract][Full Text]
204. Boettler T, Marjot T, Newsome PN, et al. Impact of COVID-19 on the care of patients with liver disease: EASL-ESCMID position paper after 6 months of the pandemic. JHEP Rep. 2020 Oct;2(5):100169.[Abstract][Full Text]
205. Segarra-Newnham M, Henneman A. Antibiotic prophylaxis for prevention of spontaneous bacterial peritonitis in patients without gastrointestinal bleeding. Ann Pharmacother. 2010 Dec;44(12):1946-54.[Abstract]
206. Bureau C, Thabut D, Jezequel C, et al. The use of rifaximin in the prevention of overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt: a randomized controlled trial. Ann Intern Med. 2021 May;174(5):633-40.[Abstract]
207. Gifford FJ, Morling JR, Fallowfield JA. Systematic review with meta-analysis: vasoactive drugs for the treatment of hepatorenal syndrome type 1. Aliment Pharmacol Ther. 2017 Mar;45(5):593-603.[Abstract][Full Text]
208. Saab S. Current treatment of thrombocytopenia in chronic liver disease. Gastroenterol Hepatol (N Y). 2019 Oct;15(10):558-60.[Abstract][Full Text]
209. O'Leary JG, Greenberg CS, Patton HM, et al. AGA clinical practice update: coagulation in cirrhosis. Gastroenterology. 2019 Jul;157(1):34-43.e1.[Abstract]
210. Shenoy A, Louissaint J, Shannon C, et al. Viscoelastic testing prior to non-surgical procedures reduces blood product use without increasing bleeding risk in cirrhosis. Dig Dis Sci. 2022 Nov;67(11):5290-9.[Abstract][Full Text]
211. Hartmann J, Dias JD, Pivalizza EG, et al. Thromboelastography-guided therapy enhances patient blood management in cirrhotic patients: a meta-analysis based on randomized controlled trials. Semin Thromb Hemost. 2023 Mar;49(2):162-72.[Abstract][Full Text]
212. Subhani M, Sheth A, Ahmed J, et al. Incidence and prevalence of venous thromboembolism in chronic liver disease: a systematic review and meta-analysis. Thromb Res. 2022 Jul;215:19-29.[Abstract][Full Text]
213. Singal AG, Zhang E, Narasimman M, et al. HCC surveillance improves early detection, curative treatment receipt, and survival in patients with cirrhosis: a meta-analysis. J Hepatol. 2022 Jul;77(1):128-39.[Abstract][Full Text]
214. Nadarevic T, Giljaca V, Colli A, et al. Computed tomography for the diagnosis of hepatocellular carcinoma in adults with chronic liver disease. Cochrane Database Syst Rev. 2021 Oct 6;10(10):CD013362.[Abstract][Full Text]
215. Singal AG, Haaland B, Parikh ND, et al. Comparison of a multitarget blood test to ultrasound and alpha-fetoprotein for hepatocellular carcinoma surveillance: results of a network meta-analysis. Hepatol Commun. 2022 Oct;6(10):2925-36.[Abstract][Full Text]
216. Moore KP, Aithal GP. Guidelines on the management of ascites in cirrhosis. Gut. 2006 Oct;55 Suppl 6:vi1-12.[Abstract][Full Text]
217. Chen N, Qiu X, Ruan H, et al. Effects of late evening snacks on glucose homeostasis in cirrhotic patients: a meta-analysis. Medicine (Baltimore). 2023 Feb 17;102(7):e32805.[Abstract][Full Text]
218. Brustia R, Savier E, Scatton O. Physical exercise in cirrhotic patients: towards prehabilitation on waiting list for liver transplantation. A systematic review and meta-analysis. Clin Res Hepatol Gastroenterol. 2018 Jun;42(3):205-15.[Abstract]
219. Locklear CT, Golabi P, Gerber L, et al. Exercise as an intervention for patients with end-stage liver disease: systematic review. Medicine (Baltimore). 2018 Oct;97(42):e12774.[Abstract][Full Text]
220. Jamali T, Raasikh T, Bustamante G, et al. Outcomes of exercise interventions in patients with advanced liver disease: a systematic review of randomized clinical trials. Am J Gastroenterol. 2022 Oct 1;117(10):1614-20.[Abstract][Full Text]
221. Corrêa FCCR, Corrêa GCCR, Silva EB. Effect of physical exercise on the functional capacity of patients with liver cirrhosis: systematic review with meta-analysis. Appl Physiol Nutr Metab. 2024 Jan 1;49(1):1-14.[Abstract]
222. Centers for Disease Control and Prevention. Adult immunization schedule by medical condition and other indication. Recommendations for ages 19 years or older, United States, 2024. Nov 2023 [internet publication].[Full Text]
223. Villanueva C, Albillos A, Genescà J, et al. Beta blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2019 Apr 20;393(10181):1597-608.[Abstract]
224. Gillespie SL, Hanrahan TP, Rockey DC, et al. Review article: controversies surrounding the use of carvedilol and other beta blockers in the management of portal hypertension and cirrhosis. Aliment Pharmacol Ther. 2023 Mar;57(5):454-63.[Abstract]
225. Villanueva C, Torres F, Sarin SK, et al. Carvedilol reduces the risk of decompensation and mortality in patients with compensated cirrhosis in a competing-risk meta-analysis. J Hepatol. 2022 Oct;77(4):1014-25.[Abstract]
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