Reversal of Liver Cirrhosis: A Desirable Clinical Outcome and Its Pathogenic Background

Bortolotti, Flavia*; Guido, Maria

Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e318032069a
Invited Review
Abstract

Cirrhosis is the final stage of chronic liver damage of various etiologies. It used to be considered an irreversible lesion, but enormous advances in our understanding of hepatic cellular and molecular biology in the past 2 decades have challenged this view. There is now substantial evidence that cirrhosis can be a reversible process. This concept is supported by an increasing number of clinical reports showing the disappearance of cirrhotic lesions from liver biopsies taken from patients cured of their liver disease. The reversal of cirrhosis usually occurs in patients with short-lived liver disease, after the successful treatment of the underlying liver damage. Recently, however, we observed the spontaneous reversal of cirrhosis after the loss of hepatitis B viremia in 2 men, 21 and 28 years old, who had developed cirrhosis as young children. Several questions and controversial issues concerning the definition of advanced cirrhosis, the limitations of liver biopsy (eg, sampling, interpretation error), and the applicability of noninvasive methods to the assessment of fibrosis, are being addressed. Future prospects include the possibility of antifibrotic therapy to prevent fibrosis or favor its degradation.

Author Information

*Clinica Medica 5, University of Padua, Italy

Pathology Department, Azienda Ospedale-University of Padua, Padova, Italy

Received 6 November, 2006

Accepted 13 December, 2006

Address correspondence and reprint requests to: Dr. Flavia Bortolotti, Clinica Medica 5, Via Giustiniani 2, 35100 Padova, Italy (e-mail: flavia.bortolotti@unipd.it).

© 2007 Lippincott Williams & Wilkins, Inc.