Answer:

End-stage liver cirrhosis, also known as decompensated cirrhosis, has a varied prognosis depending on factors such as: the degree of liver function impairment, complications, the underlying cause, age, comorbidities, and treatment response.

When liver cirrhosis becomes decompensated, patients may develop ascites, gastrointestinal bleeding due to ruptured esophageal varices, hepatic encephalopathy, infections, or hepatorenal syndrome. These complications indicate severe liver cirrhosis and significantly reduce long-term survival rates.

Therefore, it is impossible to predict precisely how long a person with end-stage liver cirrhosis will live. Your brother requires regular evaluation by a hepatobiliary specialist to determine the severity and risk of mortality. This assessment will guide decisions regarding aggressive treatment or evaluation for a liver transplant.

Doctor Hai examining a patient. Illustration: *Tam Anh General Hospital*.

Treatment for end-stage liver cirrhosis primarily aims to control the underlying causes, slow disease progression, and prevent and manage complications. Your brother should take medications as prescribed, attend regular follow-up appointments, restrict salt intake if ascites is present (as advised), maintain proper nutrition, and absolutely avoid alcohol. In some cases of alcohol-related liver disease, liver function can improve if the patient stops drinking alcohol completely and early.

The causes of liver cirrhosis are diverse, commonly including: chronic hepatitis B and C, alcohol-related liver disease, metabolic dysfunction-associated fatty liver disease, autoimmune hepatitis, and some genetic liver diseases. Correctly identifying the cause helps doctors select appropriate treatment methods. For example, patients with hepatitis B or C may receive antiviral medication as prescribed. Patients with alcohol-related cirrhosis must completely stop consuming alcohol.

For decompensated cirrhosis, a liver transplant is a treatment that can replace the severely damaged liver and improve the prognosis for those who respond well. Patients require a comprehensive evaluation of liver, kidney, heart, and lung function, nutritional status, comorbidities, and other related factors before transplantation.

The family should take the patient to a medical facility immediately if signs such as vomiting blood, black stools, rapid abdominal swelling, severe edema, increased jaundice, fever, abdominal pain, lethargy, or altered consciousness appear. These could be signs of severe complications requiring prompt management.

Second-Degree Specialist Doctor Nguyen Thi Thu Hai

Specialist in Internal Medicine - Gastroenterology - Hepatology

Tam Anh General Clinic District 7