End stage liver disease, also called cirrhosis, causes fibrosis, or scarring of liver tissue that destroys the liver's ability to perform its normal functions. Cirrhosis, the twelfth most common cause of death in the United States in 2002, lead author Joel Heidelbaugh, M.D. reports in the September 2006 issue of American Family Physician, causes many serious life threatening complications. Preventable causes of end stage liver disease include alcohol abuse, hepatitis and fatty liver disease.
Spontaneous Bacterial Peritonitis
Ascites, the accumulation of fluid in the abdomen, chest and lower extremities, occurs frequently in end stage liver disease. Infection in the fluid, called spontaneous bacterial peritonitis, or SBP, is a life threatening complication of end stage liver disease that indicates poor long term prognosis, with only 30 to 50 percent of patients surviving one year, the University of California, San Francisco reports. Ten percent of patients have no symptoms of SBP; fever, an increase in encephalopathy and abdominal pain or tenderness occur in around 50 percent or more of patients. Treatment with antibiotics cures acute infection and may also be prescribed to be taken prophylactally to prevent recurrent infection.
Hepatorenal Syndrome
Hepatorenal syndrome affects 10 percent of people with end stage liver disease, MedlinePlus reports. Hepatorenal syndrome occurs when kidney function decreases in patients with cirrhosis. Hepatorenal syndrome leads to kidney failure. Symptoms include decreased urine output, dark urine, confusions, jaundice, ascites and abnormal renal function labs. End stage kidney disease occurs, and death usually occurs from hemorrhage or infection.
Portal Hypertension
Nearly all patients with end stage liver damage develop portal hypertension, which occurs because scarring in the liver increases resistance and decreases blood flow through the portal vein into the liver. Portal hypertension causes formation of varices, dilated blood vessels, in 50 percent of people with cirrhosis. Most varices form in the esophagus, the tube between the mouth and the stomach. Between 10 and 30 percent of people with varices experience a hemorrhage, or severe blood loss, from rupture of the varices, Heidelbaugh states. In-hospital mortality from hemorrhage due to varices was 15 percent in 2000. Treatment consists of banding, or tying off the dilated blood vessels.
Liver Cancer
People with end stage liver disease have an increased risk of developing liver cancer, according to MayoClinic.com. Frequent ultrasound examinations of the liver help diagnose small cancers before they grow or spread.
