Prevention of organ failure and mortality in decompensated cirrhosis.

Decompensated cirrhosis becomes a systemic disease with a dramatic worsening of the prognosis related more to the involvement of other organs rather than to the progressive exhaustion of liver function. The progressive clinical deterioration of these patients is often dramatically accelerated by the onset of acute-on-chronic liver failure, a clinical syndrome characterized by acute decompensation of cirrhosis associated to extra-hepatic organ failure and high short-term mortality. The global management of patients with decompenstaed cirrhosis should be based on two major mainstays: 1) treatment of the underlying etiologic factors, whenever possible; 2) long-term chronic approaches targeted to antagonize key pathophysiological mechanisms aiming to reduce the incidence of acute decompensation and acute-on-chronic liver filaure, as well as reducing the economic burden of te disease.