Clinical feature One point Two points Three points Total bilirubin (mg/dL) < 2 2–3 > 3 Albumin (g/dL) > 3.5 2.8–3.5 < 2.8 INR < 1.7 1.7–2.3 > 2.3 Ascites None Mild Moderate to severe Encephalopathy…
Indications for liver transplantation Acute liver failure due to Acetaminophen overdose Idiosyncratic drug-induced liver injury Acute fatty liver of pregnancy Toxin exposure—Amanita phalloides (mushroom poisoning) Acute viral hepatitis—hepatitis A–E, herpes…
Organ/system 0 1 2 3 4 Liver (bilirubin, mg/dL) < 1.2 ≥ 1.2 to ≤ 1.9 ≥ 2 to ≤ 5.9 ≥ 6 to < 12 ≥ 12 Kidney (creatinine,…
Fig. 24.1 Factors responsible for the susceptibility of cirrhotic patients to bacterial infections. NOD2 nucleotide-binding oligomerization domain containing 2, IgA immunoglobulin A, IBO intestinal bacterial overgrowth, HLA-DR human leukocyte antigen,…
Control and patient monitoring Monitor blood pressure, heart rate and O2 saturation Control of diuresis Central or good peripheral vascular accesses Volume replacement Conservative transfusion policy to: Restore and maintain…
Fig. 8.1 Fibrosis reversibility at different states of chronic liver disease. The capacity of the liver to reverse from fibrosis or cirrhosis to a nearly normal architecture depends on the…
Fig. 21.1 The balance and rebalance of hemostasis in cirrhosis. Patients without liver disease maintain a balance of procoagulant and anticoagulant proteins. Patients with cirrhosis have decreased levels of both…
Organ or tissue Clinical syndrome or problem Role of cardiac dysfunction or problem Comments Reference (first author, year) Heart, endocardium Infective endocarditis Increased prevalence 0.34 vs. 0.1 % of noncirrhotics…
Fig. 16.1 Time course of various forms of hepatic encephalopathy (HE) depending on clinical detectability. Episodic HE in the blue lines is undetectable clinically between episodes while covert HE (black…
Fig. 9.1 a Small esophageal varices (arrows). b Large esophageal varices Screening Screening EGD should be performed at different intervals according cirrhosis status (compensated vs. decompensated) and on previous size…
