What Are the Most Critical Updates in Cirrhosis Research That Clinicians Should Be Aware Of?

Cirrhosis is often considered an irreversible liver disease, but is there a chance for early-stage reversal? In this episode, Janet Gripshover, CRNP, Nurse Manager for the Cedars-Sinai Liver Transplant Program, dives deep into the latest advancements in cirrhosis treatment, liver transplant eligibility, and the evolving landscape of transplantation. She discusses the critical role of early detection, how decompensated cirrhosis impacts survival rates, and the growing trend of earlier liver transplants across the nation.

Janet also explores how alcohol use disorder (AUD) and metabolic-associated steatotic liver disease (MASLD) are shaping transplant needs, along with groundbreaking efforts to incorporate AUD treatment into hepatology clinics. With MASLD (formerly known as NAFLD) now being the fastest-growing cause of cirrhosis and liver transplantation, she emphasizes the importance of weight loss as a key strategy for disease management. Research shows that a 7% weight loss can significantly improve liver health by mobilizing fat out of the liver and reducing disease progression.

Additionally, she highlights why identifying a surrogate decision-maker is crucial for patients with advanced cirrhosis. Once a patient experiences their first decompensated episode, the average life expectancy is less than two years, and some complications can impair decision-making. Having a surrogate involved early ensures that medical choices align with the patient’s values and preferences.

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