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Overview of Fibrosis and Cirrhosis of the Liver

By Jesse M. Civan, MD, Assistant Professor and Medical Director, Liver Tumor Center, Thomas Jefferson University Hospital

Various disorders can damage the liver. If damage is sudden (acute) and limited, the liver commonly repairs itself by making new liver cells and attaching them to the web of connective tissue (internal structure) that is left when liver cells die. Repair and full recovery can occur if people can survive long enough. However, with repeated damage, the liver's attempts to replace and repair damaged tissue lead to scarring (fibrosis). The scar tissue performs no function, and it can distort the liver's internal structure. When the scarring and distortion become widespread, cirrhosis develops. Thus, fibrosis and cirrhosis are not specific disorders. Instead, they are the result of other causes of liver damage.

The most common causes of cirrhosis in the United States are damage from alcohol (see Alcoholic Liver Disease), viral hepatitis C, and fatty liver disease (a condition in which fat is deposited in the liver, often associated with obesity and diabetes). Blockage of bile ducts, such as in primary biliary cirrhosis (now known as primary biliary cholangitis), is another cause of cirrhosis.

Usually, cirrhosis takes more than 6 months to develop after liver disease appears, but it can occur more rapidly following liver transplantation or in infants with biliary atresia.