Cirrhosis of the liver is one of the main causes of death throughout the world, according to Eldon Shafffer, M.D., professor of medicine at the University of Calgary in "The Merck Manual for Healthcare Professionals." Cirrhosis is the last stage of a damaged liver, and the organ can no longer perform all of its vital functions.
What is Cirrhosis?
Cirrhosis of the liver is the medical term for the final stage of a diseased liver. Repeated inflammation and injury has caused so much harm that the damage is now irreversible, as explained by David Geller, M.D., professor of surgery at the University of Pittsburgh in "Schwartz's Principles of Surgery." There are many fibrous scars, nodules and fibrous tissue that interfere with the functions of the liver. New blood vessels cannot handle the blood volume, resulting in a backup of blood flow, increased pressure and hypertension in the portal vein.
Functions of the Liver
The liver makes a substance called bile to help break down fats. Elizabeth Corwin, Ph.D., writes in "Handbook of Pathophysiology" that without bile, approximately 40 percent of the fats that people eat would not be metabolized, including the fat-soluble vitamins. The liver stores some toxins inside fat, while it breaks down other toxins and secretes them into the bile. It makes glucose and breaks down stored glucose, and makes most of the proteins in the plasma. The liver also has the responsibility to store iron.
Storing Iron
Large amounts of iron can be harmful to the organs. So, when old and abnormal red blood cells are removed from circulation, the iron from the blood cells joins with a protein called transferrin, explains Ernest Beutler, M.D., clinical professor of medicine at the University of California in "Williams Hematology." Transferrin takes iron to the bone marrow, to be used in new red blood cells, and to the liver. Inside the liver, the iron is attached to a protein or to apoferritin so it can be stored in the liver as ferritin.
Effect of Cirrhosis on Iron Transport
An estimated 200 billion red blood cells are broken down every day, which results in approximately 25 mg of iron to be recycled, according to Robert Murray, M.D., Ph.D., emeritus professor of biochemistry at the University of Toronto in "Harper's Illustrated Biochemistry." Transferrin, the protein that carries iron, is one of the plasma proteins made in the liver. People with cirrhosis of the liver may not be able to make the normal amount of plasma proteins.
Effect of High Iron Levels
Hemosiderosis is the medical term that describes when large amounts of iron are deposited in the tissues but do not cause any harm. In hemochromatosis, a hereditary disease, the iron causes damage. The small intestines absorb too much iron and deposit it in the pituitary gland, joints, pancreas, kidneys, heart, testes, adrenal gland, skin and liver. Liver damage is very common and can lead to cirrhosis, according to Eugene Frenkel, M.D., professor of internal medicine and radiology at the University of Texas Southwestern Medical Center in "The Merck Manual for Healthcare Professionals."
References
- "Handbook of Pathophysiology"; Elizabeth Corwin, MSN, Ph.D., FNP; 2000
- "Harper's Illustrated Biochemistry"; Robert Murray, M.D., Ph.D., David Bender, Ph.D., Kathleen Botham, Ph.D. et al.; 2009
- "Schwartz's Principles of Surgery"; F. Charles Brunicardi, M.D.; 2010
- The Merck Manual for Healthcare Professionals: Cirrhosis
- The Merck Manual for Healthcare Professionals: Hemochromatosis
- "Williams Hematology"; Marshall Lichtman, M.D., Thomas Kipps, M.D. et al.; 2010
