Decompensated cirrhosis is a term that doctors use to describe the complications of advanced liver disease. People with compensated cirrhosis often don’t have any symptoms because their liver is still properly functioning. As liver function decreases, it can become decompensated cirrhosis.
People with decompensated cirrhosis are nearing end-stage liver failure and are usually candidates for a liver transplant.
Read on to learn more about decompensated cirrhosis, including its symptoms and effects on life expectancy.
Cirrhosis usually doesn’t cause any symptoms in its earlier stages. But as it progresses to decompensated cirrhosis, it can cause:
- weight loss
- easy bleeding and bruising
- bloated abdomen due to fluid accumulation (ascites)
- swollen legs
- confusion, slurred speech, or drowsiness (hepatic encephalopathy)
- nausea and loss of appetite
- spider veins
- redness on the palms of the hands
- shrinking testicles and breast growth in men
- unexplained itchiness
Decompensated cirrhosis is an advanced stage of cirrhosis. Cirrhosis refers to scarring of the liver. Decompensated cirrhosis happens when this scarring becomes so severe that the liver can’t function properly.
Anything that damages the liver can result in scarring, which could eventually turn into decompensated cirrhosis. The most common causes of cirrhosis are:
- long-term, heavy alcohol consumption
- chronic hepatitis B or hepatitis C
- buildup of fat in the liver
Other possible causes of cirrhosis include:
- buildup of iron
- cystic fibrosis
- buildup of copper
- poorly formed bile ducts
- autoimmune diseases of the liver
- bile duct injuries
- liver infections
- taking certain medications, such as methotrexate
Generally, doctors will diagnose you with decompensated cirrhosis when you start having cirrhosis symptoms, such as jaundice or mental confusion. They’ll usually confirm the diagnosis by doing blood tests to determine liver function.
They may also take a serum sample to come up with a model for end-stage liver disease (MELD) score. The MELD score is the most commonly used diagnostic tool for advanced liver disease. Scores range from 6 to 40.
Doctors also sometimes do a liver biopsy, which involves taking a small sample of liver tissue and analyzing it. This will help them better understand how damaged your liver is.
They may also use a series of imaging tests to look at the size and shape of your liver and spleen, such as:
There are limited treatment options for decompensated cirrhosis. At this later stage of liver disease, it’s usually not possible to reverse the condition. But this also means that people with decompensated cirrhosis are often good candidates for a liver transplant.
If you have at least one symptom of decompensated cirrhosis and a MELD score of 15 or higher, a liver transplant is strongly recommended.
Liver transplants are done with either a partial or whole liver from a donor. Liver tissue can regenerate, so someone can receive a portion of a liver from a live donor. Both the transplanted liver and the donor’s liver will regenerate within a few months.
While a liver transplant is a promising option, it’s a major procedure with a lot of aspects to consider. In most cases, a doctor will refer a prospective patient to a transplant center, where a team of medical professionals will evaluate how well the patient would do with a transplant.
They’ll look at:
- liver disease stage
- medical history
- mental and emotional health
- support system at home
- ability and willingness to follow postsurgery instructions
- likelihood of surviving the surgery
To evaluate all of this, doctors use a variety of tests and procedures, such as:
- physical exams
- multiple blood tests
- psychological and social evaluations
- diagnostic tests to evaluate the health of your heart, lungs, and other organs
- imaging tests
- drug and alcohol screening
- HIV and hepatitis tests
People with alcohol- or drug-related liver disease will likely need to demonstrate their sobriety. In some cases, this might involve showing documentation from an addiction treatment facility.
Regardless of whether someone qualifies for a transplant, a doctor might also recommend the following to improve quality of life and avoid other complications:
- following a low-salt diet
- not using recreational drugs or alcohol
- taking diuretics
- taking antiviral medication to manage chronic hepatitis B or C
- limiting your fluid intake
- taking antibiotics to treat any underlying infections or prevent new ones
- taking medications to help blood clot
- taking medications to improve the flow of blood to the liver
- undergoing a procedure to remove extra fluid from the abdomen
Decompensated cirrhosis can reduce your life expectancy. Generally, the higher your MELD score, the lower your chances are for surviving another three months.
For example, if you have a MELD score of 15 or lower, you have a 95 percent chance of surviving for at least three more months. If you have a MELD score of 30, your three-month survival rate is 65 percent. This is why people with a higher MELD score are given priority on the organ donor list.
Getting a liver transplant greatly increases life expectancy. While each case is different, many people return to their usual activities after a liver transplant. The five-year survival rate is about 75 percent.
Decompensated cirrhosis is an advanced form of cirrhosis that’s associated with liver failure. While there aren’t many treatment options for it, a liver transplant can have a big impact on life expectancy.
If you’ve been diagnosed with decompensated cirrhosis, talk to your doctor about your eligibility for a transplant. They can also refer to you to a hepatologist, which is a type of doctor who specializes in treating liver conditions.