eprintid: 10129507
rev_number: 27
eprint_status: archive
userid: 608
dir: disk0/10/12/95/07
datestamp: 2021-06-14 11:29:46
lastmod: 2022-09-07 15:27:44
status_changed: 2021-06-14 11:29:46
type: article
metadata_visibility: show
creators_name: Jalan, R
creators_name: D'Amico, G
creators_name: Trebicka, J
creators_name: Moreau, R
creators_name: Angeli, P
creators_name: Arroyo, V
title: New clinical and pathophysiological perspectives defining the trajectory of cirrhosis
ispublished: pub
subjects: RFH
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
divisions: G91
keywords: Acute on chronic liver failure, Ascites, Cirrhosis, Hepatic encephalopathy, Infection, Inflammation, Varices
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
abstract: Traditionally, the complications of cirrhosis, namely variceal bleeding, ascites and hepatic encephalopathy, were thought to result predominantly from circulatory dysfunction and altered organ perfusion arising as a result of portal hypertension. Over the past 20 years, large, international prospective studies have indicated the importance of systemic inflammation and organ immunopathology as additional determinants of organ dysfunction in cirrhosis, which not only manifests in the liver, brain, circulation and the kidneys, but also the immune system, gut, muscles, adrenal glands, reproductive organs, heart and lungs. This review provides an overview of the traditional and emerging concepts around the initiation and maintenance of organ dysfunction in cirrhosis and proposes a new paradigm based upon a better understanding of acute decompensation of cirrhosis. The interaction between the traditional concepts and the emerging perspectives remains a matter of great interest and the basis for future research.
date: 2021-07-01
date_type: published
official_url: https://doi.org/10.1016/j.jhep.2021.01.018
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1868982
doi: 10.1016/j.jhep.2021.01.018
pii: S0168-8278(21)00029-5
lyricists_name: Jalan, Rajiv
lyricists_id: RJALA78
actors_name: Stacey, Thomas
actors_id: TSSTA20
actors_role: owner
full_text_status: public
publication: Journal of Hepatology
volume: 75
number: Supp 1
pagerange: S14-S26
event_location: Netherlands
citation:        Jalan, R;    D'Amico, G;    Trebicka, J;    Moreau, R;    Angeli, P;    Arroyo, V;      (2021)    New clinical and pathophysiological perspectives defining the trajectory of cirrhosis.                   Journal of Hepatology , 75  (Supp 1)   S14-S26.    10.1016/j.jhep.2021.01.018 <https://doi.org/10.1016/j.jhep.2021.01.018>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10129507/1/Jalan_New%20Clinical%20and%20Pathophysiological%20Perspectives%20defining%20the%20Trajectory%20of%20Cirrhosis.pdf