Clinical aspects of hepatic problems

Abstract 

Advanced liver disease is a classic example of multisystem failure resulting from a single-organ disease. Historically, even minor surgery on patients with cirrhosis resulted in high mortality. Liver transplantation has dramatically improved the prognosis for these patients. It is important for clinicians to understand the multisystem sequelae of end-stage liver disease in order to assess risk and manage patients appropriately. Recognition of severe disease is crucial; improved perioperative care has not significantly reduced operative mortality. These patients should be referred for transplant assessment or, if surgery for unrelated conditions is considered, should be managed in specialist centres.

Keywords: cardiomyopathy, cirrhosis, coagulopathy, encephalopathy, hepatic failure, hepatopulmonary syndrome, hepatorenal syndrome, portopulmonary hypertension