Cirrhotic Multiorgan Syndrome

Dig Dis Sci. 2015 Nov;60(11):3209-25. doi: 10.1007/s10620-015-3752-3. Epub 2015 Jun 26.

Abstract

Patients with cirrhosis and portal hypertension are at an increased risk of the development of circulatory dysfunction that may potentially result in multiple organ failure. Apart from the liver, this may involve the heart, lungs, kidneys, the immune system, the adrenal glands, and other organ systems. As the disease progresses, the circulation becomes hyperdynamic, and signs of cardiac, pulmonary, and renal dysfunction are observed, in addition to reduced survival. Infections and an altered cardiac function known as cirrhotic cardiomyopathy may be precipitators for the development of other complications such as hepatorenal syndrome. In patients with chronic organ dysfunction, various precipitating events may induce an acute-on-chronic renal failure and acute-on-chronic liver failure that negatively affect the prognosis. Future research on the pathophysiologic mechanisms of the complications and the precipitating factors is essential to understand the basics of the treatment of these challenging conditions. The aim of the present review is to focus on the development and precipitating factors of various organ failures in patients with decompensated cirrhosis.

Keywords: Cirrhosis; Cirrhotic cardiomyopathy; Hyperdynamic syndrome; Portal hypertension; Pulmonary dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / physiopathology
  • Acute-On-Chronic Liver Failure / diagnosis
  • Acute-On-Chronic Liver Failure / etiology
  • Acute-On-Chronic Liver Failure / physiopathology
  • Animals
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / etiology
  • Cardiomyopathies / physiopathology
  • Disease Progression
  • Hemodynamics
  • Humans
  • Hypertension, Portal / diagnosis
  • Hypertension, Portal / etiology*
  • Hypertension, Portal / physiopathology
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / physiopathology
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / physiopathology
  • Multiple Organ Failure / diagnosis
  • Multiple Organ Failure / etiology*
  • Multiple Organ Failure / physiopathology
  • Prognosis
  • Risk Factors
  • Syndrome