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Pathophysiology of Chronic Liver Disease

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Peri-operative Anesthetic Management in Liver Transplantation

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Abstract

The liver being the largest solid organ in the human body is affected by many different pathogenic agents and processes. Increasing incidence of liver disease is primarily driven by lifestyle factors (alcohol, obesity) and infection of the liver parenchyma. Liver diseases can be manifested in a number of ways, which may be acute or chronic, focal or diffuse, mild or severe. Acute liver disease is a self-limiting disease in which symptoms do not persist beyond 6 months. Most cases are due to episodes of hepatocyte inflammation or damage, which resolve without causing any further complications. Mostly the manifestation of acute liver disease (e.g., viral hepatitis) is so mild that they never come to medical attention. However the entire liver may be affected in few cases leading to fulminant liver failure, which is a life-threatening condition. In chronic liver disease the symptoms persist for more than 6 months. It occurs because of permanent structural damage to the liver architecture as a result of continued inflammation of the hepatocytes after the primary insult. Cirrhosis is the ultimate consequence of progressive liver injury. Cirrhosis develops in a subset of cases of chronic liver disease and may be a consequence of repeated episodes of acute liver injury. Cirrhosis is manifested as a grossly impaired liver function due to decrease amount of functional liver tissue. Change in liver architecture leads to change in the physics of blood flow in and around the liver. Elevation in portal vein pressure diverts blood away from the liver causing portosystemic shunting, which has a profound effect on functioning of various organ systems.

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Author information

Authors and Affiliations

  1. Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India

    Anjan Trikha & Bikash Ranjan Ray

Authors
  1. Anjan Trikha
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  2. Bikash Ranjan Ray
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Editor information

Editors and Affiliations

  1. Liver Transplant, GI Anesthesia & Intensive Care, Medanta The Medicity, Gurgaon, India

    Vijay Vohra

  2. Liver Transplant, GI Anesthesia & Critical Care, Medanta The Medicity, Gurgaon, Haryana, India

    Nikunj Gupta

  3. Liver Transplant & General Anaesthesia, Narayana Superspeciality Hospital, Gurgaon, India

    Annu Sarin Jolly

  4. Liver Transplant, GI Anesthesia & Critical Care, Formerly at Medanta The Medicity, Gurgaon, India

    Seema Bhalotra

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Trikha, A., Ray, B.R. (2023). Pathophysiology of Chronic Liver Disease. In: Vohra, V., Gupta, N., Jolly, A.S., Bhalotra, S. (eds) Peri-operative Anesthetic Management in Liver Transplantation. Springer, Singapore. https://doi.org/10.1007/978-981-19-6045-1_4

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  • DOI: https://doi.org/10.1007/978-981-19-6045-1_4

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  • Online ISBN: 978-981-19-6045-1

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