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World J Gastroenterol. Nov 14, 2014; 20(42): 15499-15517
Published online Nov 14, 2014. doi: 10.3748/wjg.v20.i42.15499
Extrahepatic complications to cirrhosis and portal hypertension: Haemodynamic and homeostatic aspects
Søren Møller, Jens H Henriksen, Flemming Bendtsen
Søren Møller, Jens H Henriksen, Department of Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, University of Copenhagen, DK.2650 Hvidovre, Denmark
Flemming Bendtsen, Gastro Unit, Medical Division, Hvidovre Hospital, Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, DK.2650 Hvidovre, Denmark
Author contributions: Møller S primarily wrote the paper; Henriksen JH and Bendtsen F commented and expanded the content.
Supported by Novo Nordisk Foundation and the University of Copenhagen
Correspondence to: Søren Møller, MD, DMSc, Professor, Department of Clinical Physiology and Nuclear Medicine 239, Centre for Functional Imaging and Research, Copenhagen University Hospital, University of Copenhagen, Kettegaarda alle 30, DK.2650 Hvidovre, Denmark. soeren.moeller@regionh.dk
Telephone: +45-38-623568  Fax: +45-38-623750
Received: October 30, 2013
Revised: March 6, 2014
Accepted: June 20, 2014
Published online: November 14, 2014
Core Tip

Core tip: Patients with cirrhosis develop extrahepatic functional disturbances as a multiple organ failure that involves the heart, lungs, kidneys, the immune systems, and other organ systems. Fibrosis of the liver leads to a systemic vasodilatation that affects both the homeostasis of many organ systems. The circulation becomes hyperdynamic, which is often further aggravated by infections. Changes in organ function involve the heart as a cirrhotic cardiomyopathy, the kidneys such as the hepatorenal syndrome and the lungs with development of a hepatopulmonary syndrome. Liver transplantation is often the only radical treatment and as a bridge to this treatment, knowledge on the mechanisms of the pathophysiology of complications is essential.