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Leberzirrhose und deren Komplikationen

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Pathologie

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Dieses Kapitel beschreibt das Endstadium einer Fibrosierung der Leber mit Umbau des Gewebes zu diffusen Regeneratknoten mit fibrösen Septen, die sich als Reaktion auf eine chronische, meist inflammatorische Schädigung des Parenchyms entwickeln. Es wird ein aktueller Überblick über die mit der Progression der Erkrankungen einhergehenden hämodynamischen Veränderungen und deren Folgen sowie über die Fortschritte auf dem Gebiet der nichtinvasiven Fibrosediagnostik gegeben. Ein besonderer Schwerpunkt liegt dabei auf der Beschreibung der Zirrhose-assoziierten Komplikationen und deren pathophysiologischen Grundlagen. Die Leberzirrhose als komplexe Multisystemerkrankung mit weitreichenden Auswirkungen auf verschiedene Organsysteme zu verstehen, ist Voraussetzung für die Entwicklung neuer und dringend benötigter therapeutischer Interventionen.

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Literatur

  1. European Association for Study of Liver, Asociacion Latinoamericana para el Estudio del Higado (2015) EASL-ALEH clinical practice guidelines: non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol 63:237–264

    Article  Google Scholar 

  2. Acevedo JG, Cramp ME (2017) Hepatorenal syndrome: update on diagnosis and therapy. World J Hepatol 9:293–299

    Article  PubMed  PubMed Central  Google Scholar 

  3. Adebayo D, Morabito V, Davenport A, Jalan R (2015) Renal dysfunction in cirrhosis is not just a vasomotor nephropathy. Kidney Int 87:509–515

    Article  PubMed  Google Scholar 

  4. Aldenkortt F, Aldenkortt M, Caviezel L, Waeber JL, Weber A, Schiffer E (2014) Portopulmonary hypertension and hepatopulmonary syndrome. World J Gastroenterol 20:8072–8081

    Article  PubMed  PubMed Central  Google Scholar 

  5. Arroyo V, Moreau R, Jalan R, Gines P (2015) Acute-on-chronic liver failure: a new syndrome that will re-classify cirrhosis. J Hepatol 62:131–143

    Article  Google Scholar 

  6. Arvaniti V, D’Amico G, Fede G, Manousou P, Tsochatzis E, Pleguezuelo M, Burroughs AK (2010) Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis. Gastroenterology 139:1246–1256.e5

    Article  PubMed  Google Scholar 

  7. Augustin S, Pons M, Maurice JB, Bureau C, Stefanescu H, Ney M, Blasco H, Procopet B, Tsochatzis E, Westbrook RH, Bosch J, Berzigotti A, Abraldes JG, Genesca J (2017) Expanding the Baveno VI criteria for the screening of varices in patients with compensated advanced chronic liver disease. Hepatology 66:1980–1988

    Article  PubMed  Google Scholar 

  8. Batts KP, Ludwig J (1995) Chronic hepatitis. An update on terminology and reporting. Am J Surg Pathol 19:1409–1417

    Article  CAS  PubMed  Google Scholar 

  9. Bedossa P, Dargere D, Paradis V (2003) Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology 38:1449–1457

    Article  PubMed  Google Scholar 

  10. Bismuth M, Funakoshi N, Cadranel JF, Blanc P (2011) Hepatic encephalopathy: from pathophysiology to therapeutic management. Eur J Gastroenterol Hepatol 23:8–22

    Article  PubMed  Google Scholar 

  11. Bloom S, Kemp W, Lubel J (2015) Portal hypertension: pathophysiology, diagnosis and management. Int Med J 45:16–26

    Article  CAS  Google Scholar 

  12. Bolognesi M, Merkel C, Sacerdoti D, Nava V, Gatta A (2002) Role of spleen enlargement in cirrhosis with portal hypertension. Dig Liver Dis 34:144–150

    Article  CAS  PubMed  Google Scholar 

  13. Bosch J, Iwakiri Y (2018) The portal hypertension syndrome: etiology, classification, relevance, and animal models. Hepatol Int 12:1–10

    Article  PubMed  Google Scholar 

  14. Brunt EM (2000) Grading and staging the histopathological lesions of chronic hepatitis: the Knodell histology activity index and beyond. Hepatology 31:241–246

    Article  CAS  PubMed  Google Scholar 

  15. Cai Y, Liu Z, Liu X (2014) Laparoscopic versus open splenectomy for portal hypertension: a systematic review of comparative studies. Surg Innov 21:442–447

    Article  PubMed  Google Scholar 

  16. Campagna F, Montagnese S, Ridola L, Senzolo M, Schiff S, De Rui M, Pasquale C, Nardelli S, Pentassuglio I, Merkel C, Angeli P, Riggio O, Amodio P (2017) The animal naming test: An easy tool for the assessment of hepatic encephalopathy. Hepatology 66:198–208

    Article  PubMed  Google Scholar 

  17. Castera L, Pinzani M (2010) Biopsy and non-invasive methods for the diagnosis of liver fibrosis: does it take two to tango? Gut 59:861–866

    Article  PubMed  Google Scholar 

  18. Chayanupatkul M, Liangpunsakul S (2014) Cirrhotic cardiomyopathy: review of pathophysiology and treatment. Hepatol Int 8:308–315

    Article  PubMed  Google Scholar 

  19. Coltart I, Tranah TH, Shawcross DL (2013) Inflammation and hepatic encephalopathy. Arch Biochem Biophys 536:189–196

    Article  CAS  PubMed  Google Scholar 

  20. D’Amico G, Pasta L, Morabito A, D’Amico M, Caltagirone M, Malizia G, Tine F, Giannuoli G, Traina M, Vizzini G, Politi F, Luca A, Virdone R, Licata A, Pagliaro L (2014) Competing risks and prognostic stages of cirrhosis: a 25-year inception cohort study of 494 patients. Aliment Pharmacol Ther 39:1180–1193

    Article  PubMed  Google Scholar 

  21. Dasarathy S, Merli M (2016) Sarcopenia from mechanism to diagnosis and treatment in liver disease. J Hepatol 65:1232–1244

    Article  PubMed  PubMed Central  Google Scholar 

  22. de Franchis R (2015) Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol 63:743–752

    Article  PubMed  Google Scholar 

  23. Durand F, Buyse S, Francoz C, Laouenan C, Bruno O, Belghiti J, Moreau R, Vilgrain V, Valla D (2014) Prognostic value of muscle atrophy in cirrhosis using psoas muscle thickness on computed tomography. J Hepatol 60:1151–1157

    Article  PubMed  Google Scholar 

  24. Fede G, D’Amico G, Arvaniti V, Tsochatzis E, Germani G, Georgiadis D, Morabito A, Burroughs AK (2012) Renal failure and cirrhosis: a systematic review of mortality and prognosis. J Hepatol 56:810–818

    Article  PubMed  Google Scholar 

  25. Ferenci P, Lockwood A, Mullen K, Tater R, Weissenborn K, Blei A, et al. Hepatic encephalopathy – definition, nomenclature, diagnosis and quantification: final report of the Working Party at the 11th World Congress of Gastroenterology, Vienna, 1998. Hepatology 2002;35:716–721.

    Google Scholar 

  26. Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT (2002) Hepatic encephalopathy – definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology 35:716–721

    Article  PubMed  Google Scholar 

  27. Fernandez J, Acevedo J, Wiest R, Gustot T, Amoros A, Deulofeu C, Reverter E, Martinez J, Saliba F, Jalan R, Welzel T, Pavesi M, Hernandez-Tejero M, Gines P, Arroyo V (2018) Bacterial and fungal infections in acute-on-chronic liver failure: prevalence, characteristics and impact on prognosis. Gut 67:1870–1880

    Article  CAS  PubMed  Google Scholar 

  28. Friedrich-Rust M, Nierhoff J, Lupsor M, Sporea I, Fierbinteanu-Braticevici C, Strobel D, Takahashi H, Yoneda M, Suda T, Zeuzem S, Herrmann E (2012) Performance of acoustic radiation force impulse imaging for the staging of liver fibrosis: a pooled meta-analysis. J Viral Hepat 19:e212–e219

    Article  CAS  PubMed  Google Scholar 

  29. Friedrich-Rust M, Ong MF, Martens S, Sarrazin C, Bojunga J, Zeuzem S, Herrmann E (2008) Performance of transient elastography for the staging of liver fibrosis: a meta-analysis. Gastroenterology 134:960–974

    Article  PubMed  Google Scholar 

  30. Garcia-Tsao G, Friedman S, Iredale J, Pinzani M (2010) Now there are many (stages) where before there was one: In search of a pathophysiological classification of cirrhosis. Hepatology 51:1445–1449

    Article  PubMed  Google Scholar 

  31. Giusto M, Lattanzi B, Albanese C, Galtieri A, Farcomeni A, Giannelli V, Lucidi C, Di Martino M, Catalano C, Merli M (2015) Sarcopenia in liver cirrhosis: the role of computed tomography scan for the assessment of muscle mass compared with dual-energy x-ray absorptiometry and anthropometry. Eur J Gastroenterol Hepatol 27:328–334

    Article  PubMed  Google Scholar 

  32. Glass C, Hipskind P, Tsien C, Malin SK, Kasumov T, Shah SN, Kirwan JP, Dasarathy S (2013) Sarcopenia and a physiologically low respiratory quotient in patients with cirrhosis: a prospective controlled study. J Appl Physiol (1985) 114:559–565

    Article  CAS  Google Scholar 

  33. Groszmann RJ, Garcia-Tsao G, Bosch J, Grace ND, Burroughs AK, Planas R, Escorsell A, Garcia-Pagan JC, Patch D, Matloff DS, Gao H, Makuch R (2005) Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis. N Engl J Med 353:2254–2261

    Article  CAS  PubMed  Google Scholar 

  34. Gupta S, Faughnan ME, Lilly L, Hutchison S, Fowler R, Bayoumi AM (2010) Norfloxacin therapy for hepatopulmonary syndrome: a pilot randomized controlled trial. Clin Gastroenterol Hepatol 8:1095–1098

    Article  CAS  PubMed  Google Scholar 

  35. Gustot T, Fernandez J, Garcia E, Morando F, Caraceni P, Alessandria C, Laleman W, Trebicka J, Elkrief L, Hopf C, Solis-Munoz P, Saliba F, Zeuzem S, Albillos A, Benten D, Montero-Alvarez JL, Chivas MT, Concepcion M, Cordoba J, McCormick A, Stauber R, Vogel W, de Gottardi A, Welzel TM, Domenicali M, Risso A, Wendon J, Deulofeu C, Angeli P, Durand F, Pavesi M, Gerbes A, Jalan R, Moreau R, Gines P, Bernardi M, Arroyo V (2015) Clinical course of acute-on-chronic liver failure syndrome and effects on prognosis. Hepatology 62:243–252

    Article  PubMed  Google Scholar 

  36. Halank M, Strassburg CP, Hoeper MM (2010) Pulmonary complications of liver cirrhosis: hepatopulmonary syndrome, portopulmonary hypertension and hepatic hydrothorax. Internist 51(Suppl 1):255–263

    Article  Google Scholar 

  37. Hernaez R, Sola E, Moreau R, Gines P (2017) Acute-on-chronic liver failure: an update. Gut 66:541–553

    Article  CAS  PubMed  Google Scholar 

  38. Hoeper MM, Andreas S, Bastian A, Claussen M, Ghofrani HA, Gorenflo M, Grohe C, Gunther A, Halank M, Hammerl P, Held M, Kruger S, Lange TJ, Reichenberger F, Sablotzki A, Staehler G, Stark W, Wirtz H, Witt C, Behr J (2011) Pulmonary hypertension due to chronic lung disease. Recommendations of the Cologne Consensus Conference 2010. Pneumologie 65:208–218

    Article  CAS  PubMed  Google Scholar 

  39. Hoeper MM, Seyfarth HJ, Hoeffken G, Wirtz H, Spiekerkoetter E, Pletz MW, Welte T, Halank M (2007) Experience with inhaled iloprost and bosentan in portopulmonary hypertension. Eur Resp J 30:1096–1102

    Article  CAS  Google Scholar 

  40. Jalan R, Fernandez J, Wiest R, Schnabl B, Moreau R, Angeli P, Stadlbauer V, Gustot T, Bernardi M, Canton R, Albillos A, Lammert F, Wilmer A, Mookerjee R, Vila J, Garcia-Martinez R, Wendon J, Such J, Cordoba J, Sanyal A, Garcia-Tsao G, Arroyo V, Burroughs A, Gines P (2014) Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference 2013. J Hepatol 60:1310–1324

    Article  PubMed  Google Scholar 

  41. Jalan R, Gines P, Olson JC, Mookerjee RP, Moreau R, Garcia-Tsao G, Arroyo V, Kamath PS (2012) Acute-on chronic liver failure. J Hepatol 57:1336–1348

    Article  PubMed  Google Scholar 

  42. Jalan R, Pavesi M, Saliba F, Amoros A, Fernandez J, Holland-Fischer P, Sawhney R, Mookerjee R, Caraceni P, Moreau R, Gines P, Durand F, Angeli P, Alessandria C, Laleman W, Trebicka J, Samuel D, Zeuzem S, Gustot T, Gerbes AL, Wendon J, Bernardi M, Arroyo V (2015) The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure. J Hepatol 62:831–840

    Article  PubMed  Google Scholar 

  43. Jalan R, Saliba F, Pavesi M, Amoros A, Moreau R, Gines P, Levesque E, Durand F, Angeli P, Caraceni P, Hopf C, Alessandria C, Rodriguez E, Solis-Munoz P, Laleman W, Trebicka J, Zeuzem S, Gustot T, Mookerjee R, Elkrief L, Soriano G, Cordoba J, Morando F, Gerbes A, Agarwal B, Samuel D, Bernardi M, Arroyo V (2014) Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J Hepatol 61:1038–1047

    Article  PubMed  Google Scholar 

  44. Jara M, Bednarsch J, Lock JF, Malinowski M, Schulz A, Seehofer D, Stockmann M (2014) Enhancing safety in liver surgery using a new diagnostic tool for evaluation of actual liver function capacity – The LiMAx test. Dtsch Med Wochenschr 139:387–391

    Article  CAS  PubMed  Google Scholar 

  45. Jara M, Reese T, Malinowski M, Valle E, Seehofer D, Puhl G, Neuhaus P, Pratschke J, Stockmann M (2015) Reductions in post-hepatectomy liver failure and related mortality after implementation of the LiMAx algorithm in preoperative work-up: a single-centre analysis of 1170 hepatectomies of one or more segments. HPB 17:651–658

    Article  PubMed  PubMed Central  Google Scholar 

  46. Kim MY, Cho MY, Baik SK, Park HJ, Jeon HK, Im CK, Won CS, Kim JW, Kim HS, Kwon SO, Eom MS, Cha SH, Kim YJ, Chang SJ, Lee SS (2011) Histological subclassification of cirrhosis using the Laennec fibrosis scoring system correlates with clinical stage and grade of portal hypertension. J Hepatol 55:1004–1009

    Article  PubMed  Google Scholar 

  47. Kovarik M, Muthny T, Sispera L, Holecek M (2012) The dose-dependent effects of endotoxin on protein metabolism in two types of rat skeletal muscle. J Physiol Biochem 68:385–395

    Article  CAS  PubMed  Google Scholar 

  48. Krug S, Seyfarth HJ, Hagendorff A, Wirtz H (2007) Inhaled iloprost for hepatopulmonary syndrome: improvement of hypoxemia. Eur J Gastroenterol Hepatol 19:1140–1143

    Article  PubMed  Google Scholar 

  49. Le Pavec J, Souza R, Herve P, Lebrec D, Savale L, Tcherakian C, Jais X, Yaici A, Humbert M, Simonneau G, Sitbon O (2008) Portopulmonary hypertension: survival and prognostic factors. Am J Respir Crit Care Med 178:637–643

    Article  PubMed  Google Scholar 

  50. Linecker M, Krones T, Berg T, Niemann CU, Steadman RH, Dutkowski P, Clavien PA, Busuttil RW, Truog RD, Petrowsky H (2018) Potentially inappropriate liver transplantation in the era of the “sickest first” policy – a search for the upper limits. J Hepatol 68:798–813

    Article  PubMed  Google Scholar 

  51. Maharaj B, Maharaj RJ, Leary WP, Cooppan RM, Naran AD, Pirie D, Pudifin DJ (1986) Sampling variability and its influence on the diagnostic yield of percutaneous needle biopsy of the liver. Lancet 1:523–525

    Article  CAS  PubMed  Google Scholar 

  52. McConnell M, Iwakiri Y (2018) Biology of portal hypertension. Hepatol Int 12:11–23

    Article  PubMed  Google Scholar 

  53. Merli M, Giusto M, Molfino A, Bonetto A, Rossi M, Ginanni Corradini S, Baccino FM, Rossi Fanelli F, Costelli P, Muscaritoli M (2013) MuRF-1 and p-GSK3beta expression in muscle atrophy of cirrhosis. Liver Int 33:714–721

    Article  CAS  PubMed  Google Scholar 

  54. Meza-Junco J, Montano-Loza AJ, Baracos VE, Prado CM, Bain VG, Beaumont C, Esfandiari N, Lieffers JR, Sawyer MB (2013) Sarcopenia as a prognostic index of nutritional status in concurrent cirrhosis and hepatocellular carcinoma. J Clin Gastroenterol 47:861–870

    Article  PubMed  Google Scholar 

  55. Moller S, Bendtsen F (2018) The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis. Liver Int 38:570–580

    Article  PubMed  Google Scholar 

  56. Moller S, Henriksen JH (2010) Cirrhotic cardiomyopathy. J Hepatol 53:179–190

    Article  PubMed  Google Scholar 

  57. Montano-Loza AJ, Meza-Junco J, Prado CM, Lieffers JR, Baracos VE, Bain VG, Sawyer MB (2012) Muscle wasting is associated with mortality in patients with cirrhosis. Clin Gastroenterol Hepatol 10:166–173.e1

    Article  PubMed  Google Scholar 

  58. Moreau R (2015) Role of infections in acute-on-chronic liver failure. Dig Dis 33:577–581

    Article  PubMed  Google Scholar 

  59. Moreau R, Jalan R, Gines P, Pavesi M, Angeli P, Cordoba J, Durand F, Gustot T, Saliba F, Domenicali M, Gerbes A, Wendon J, Alessandria C, Laleman W, Zeuzem S, Trebicka J, Bernardi M, Arroyo V (2013) Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology 144:1426–1437e.9

    Article  PubMed  Google Scholar 

  60. Neuschwander-Tetri BA, Caldwell SH (2003) Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology 37:1202–1219

    Article  PubMed  Google Scholar 

  61. Olde Damink SW, Jalan R, Deutz NE, Redhead DN, Dejong CH, Hynd P, Jalan RA, Hayes PC, Soeters PB (2003) The kidney plays a major role in the hyperammonemia seen after simulated or actual GI bleeding in patients with cirrhosis. Hepatology 37:1277–1285

    Article  PubMed  Google Scholar 

  62. Pedersen BK, Febbraio MA (2012) Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol 8:457–465

    Article  CAS  PubMed  Google Scholar 

  63. Pinzani M, Rosselli M, Zuckermann M (2011) Liver cirrhosis. Best Pract Res Clin Gastroenterol 25:281–290

    Article  CAS  PubMed  Google Scholar 

  64. Pinzani M, Vizzutti F, Arena U, Marra F (2008) Technology Insight: noninvasive assessment of liver fibrosis by biochemical scores and elastography. Nat Clin Pract Gastroenterol Hepatol 5:95–106

    Article  CAS  PubMed  Google Scholar 

  65. Planas R, Montoliu S, Balleste B, Rivera M, Miquel M, Masnou H, Galeras JA, Gimenez MD, Santos J, Cirera I, Morillas RM, Coll S, Sola R (2006) Natural history of patients hospitalized for management of cirrhotic ascites. Clin Gastroenterol Hepatol 4:1385–1394

    Article  PubMed  Google Scholar 

  66. Praktiknjo M, Book M, Luetkens J, Pohlmann A, Meyer C, Thomas D, Jansen C, Feist A, Chang J, Grimm J, Lehmann J, Strassburg CP, Abraldes JG, Kukuk G, Trebicka J (2018) Fat-free muscle mass in magnetic resonance imaging predicts acute-on-chronic liver failure and survival in decompensated cirrhosis. Hepatology 67:1014–1026

    Article  CAS  PubMed  Google Scholar 

  67. Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R (1973) Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 60:646–649

    Article  CAS  PubMed  Google Scholar 

  68. Rastogi A, Maiwall R, Bihari C, Ahuja A, Kumar A, Singh T, Wani ZA, Sarin SK (2013) Cirrhosis histology and Laennec staging system correlate with high portal pressure. Histopathology 62:731–741

    Article  PubMed  Google Scholar 

  69. Ripoll C, Groszmann R, Garcia-Tsao G, Grace N, Burroughs A, Planas R, Escorsell A, Garcia-Pagan JC, Makuch R, Patch D, Matloff DS, Bosch J (2007) Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Gastroenterology 133:481–488

    Article  CAS  PubMed  Google Scholar 

  70. Ripoll C, Groszmann RJ, Garcia-Tsao G, Bosch J, Grace N, Burroughs A, Planas R, Escorsell A, Garcia-Pagan JC, Makuch R, Patch D, Matloff DS (2009) Hepatic venous pressure gradient predicts development of hepatocellular carcinoma independently of severity of cirrhosis. J Hepatol 50:923–928

    Article  PubMed  PubMed Central  Google Scholar 

  71. Roccarina D, Rosselli M, Genesca J, Tsochatzis EA (2018) Elastography methods for the non-invasive assessment of portal hypertension. Expert Rev Gastroenterol Hepatol 12:155–164

    Article  CAS  PubMed  Google Scholar 

  72. Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD (2009) Liver biopsy. Hepatology 49:1017–1044

    Article  PubMed  Google Scholar 

  73. Rodriguez-Roisin R, Krowka MJ (2008) Hepatopulmonary syndrome – a liver-induced lung vascular disorder. N Engl J Med 358:2378–2387

    Article  CAS  PubMed  Google Scholar 

  74. Romero-Gomez M, Montagnese S, Jalan R (2015) Hepatic encephalopathy in patients with acute decompensation of cirrhosis and acute-on-chronic liver failure. J Hepatol 62:437–447

    Article  CAS  PubMed  Google Scholar 

  75. Salerno F, Camma C, Enea M, Rossle M, Wong F (2007) Transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis of individual patient data. Gastroenterology 133:825–834

    Article  CAS  PubMed  Google Scholar 

  76. Savale L, Sattler C, Coilly A, Conti F, Renard S, Francoz C, Bouvaist H, Feray C, Borentain P, Jais X, Montani D, Parent F, O’Connell C, Herve P, Humbert M, Simonneau G, Samuel D, Calmus Y, Duvoux C, Durand F, Duclos-Vallee JC, Sitbon O (2017) Long-term outcome in liver transplantation candidates with portopulmonary hypertension. Hepatology 65:1683–1692

    Article  CAS  PubMed  Google Scholar 

  77. Schirmacher P, Fleig WE, Tannapfel A, Langner C, Dries V, Terracciano L, Denk H, Dienes HP (2004) Bioptic diagnosis of chronic hepatitis. Results of an evidence-based consensus conference of the German Society of Pathology, of the German Society for Digestive and Metabolic Diseases and of Compensated Hepatitis (HepNet). Pathologe 25:337–348

    Article  CAS  PubMed  Google Scholar 

  78. Schuppan D, Surabattula R, Wang XY (2018) Determinants of fibrosis progression and regression in NASH. J Hepatol 68:238–250

    Article  CAS  PubMed  Google Scholar 

  79. Sebastiani G, Castera L, Halfon P, Pol S, Mangia A, Di Marco V, Pirisi M, Voiculescu M, Bourliere M, Alberti A (2011) The impact of liver disease aetiology and the stages of hepatic fibrosis on the performance of non-invasive fibrosis biomarkers: an international study of 2411 cases. Aliment Pharmacol Ther 34:1202–1216

    Article  CAS  PubMed  Google Scholar 

  80. Simonneau G, Gatzoulis MA, Adatia I, Celermajer D, Denton C, Ghofrani A, Gomez Sanchez MA, Krishna Kumar R, Landzberg M, Machado RF, Olschewski H, Robbins IM, Souza R (2013) Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 62:D34–D41

    Article  PubMed  Google Scholar 

  81. Sinclair M, Gow PJ, Grossmann M, Angus PW (2016) Review article: sarcopenia in cirrhosis – aetiology, implications and potential therapeutic interventions. Aliment Pharmacol Ther 43:765–777

    Article  CAS  PubMed  Google Scholar 

  82. Sinclair M, Grossmann M, Hoermann R, Angus PW, Gow PJ (2016) Testosterone therapy increases muscle mass in men with cirrhosis and low testosterone: a randomised controlled trial. J Hepatol 65:906–913

    Article  CAS  PubMed  Google Scholar 

  83. Stockmann M, Lock JF, Malinowski M, Niehues SM, Seehofer D, Neuhaus P (2010) The LiMAx test: a new liver function test for predicting postoperative outcome in liver surgery. HPB 12:139–146

    Article  PubMed  PubMed Central  Google Scholar 

  84. Tandon P, Ney M, Irwin I, Ma MM, Gramlich L, Bain VG, Esfandiari N, Baracos V, Montano-Loza AJ, Myers RP (2012) Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value. Liver Transpl 18:1209–1216

    Article  PubMed  Google Scholar 

  85. Tsien C, Shah SN, McCullough AJ, Dasarathy S (2013) Reversal of sarcopenia predicts survival after a transjugular intrahepatic portosystemic stent. Eur J Gastroenterol Hepatol 25:85–93

    Article  PubMed  Google Scholar 

  86. Tsochatzis EA, Bosch J, Burroughs AK (2014) Liver cirrhosis. Lancet 383:1749–1761

    Article  PubMed  Google Scholar 

  87. van Vugt JLA, Buettner S, Alferink LJM, Bossche N, de Bruin RWF, Darwish Murad S, Polak WG, Metselaar HJ, IJzermans JNM (2018) Low skeletal muscle mass is associated with increased hospital costs in patients with cirrhosis listed for liver transplantation – a retrospective study. Transplant Int 31:165–174

    Article  Google Scholar 

  88. Wang CW, Feng S, Covinsky KE, Hayssen H, Zhou LQ, Yeh BM, Lai JC (2016) A comparison of muscle function, mass, and quality in liver transplant candidates: results from the functional assessment in Liver Transplantation Study. Transplantation 100:1692–1698

    Article  PubMed  PubMed Central  Google Scholar 

  89. Wijdicks EF (2016) Hepatic encephalopathy. N Engl J Med 375:1660–1670

    Article  CAS  PubMed  Google Scholar 

  90. Xu RY, Liu B, Lin N (2004) Therapeutic effects of endoscopic variceal ligation combined with partial splenic embolization for portal hypertension. World J Gastroenterol 10:1072–1074

    Article  PubMed  PubMed Central  Google Scholar 

  91. Yadav A, Chang YH, Carpenter S, Silva AC, Rakela J, Aqel BA, Byrne TJ, Douglas DD, Vargas HE, Carey EJ (2015) Relationship between sarcopenia, six-minute walk distance and health-related quality of life in liver transplant candidates. Clin Transplant 29:134–141

    Article  PubMed  Google Scholar 

  92. Zhan T, Stremmel W (2012) The diagnosis and treatment of minimal hepatic encephalopathy. Dtsch Ärztebl Int 109:180–187

    PubMed  PubMed Central  Google Scholar 

  93. Zipprich A, Garcia-Tsao G, Rogowski S, Fleig WE, Seufferlein T, Dollinger MM (2012) Prognostic indicators of survival in patients with compensated and decompensated cirrhosis. Liver Int 32:1407–1414

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Correspondence to Cornelius Engelmann .

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© 2020 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

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Engelmann, C., Böhlig, A., Berg, T. (2020). Leberzirrhose und deren Komplikationen. In: Tannapfel, A., Klöppel, G. (eds) Pathologie. Pathologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-04557-8_10

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