Clinical meaning
Cirrhosis is the end-stage of chronic liver disease characterized by diffuse fibrosis, regenerative nodule formation, and distortion of hepatic architecture. Chronic injury (alcohol, viral hepatitis, NAFLD/NASH) activates hepatic stellate cells, which transform from quiescent vitamin A-storing cells into myofibroblasts that produce excessive collagen (types I and III), forming fibrous septa that disrupt normal lobular architecture. This creates portosystemic shunting, impaired hepatocyte function, and portal hypertension (hepatic venous pressure gradient >5 mmHg; clinically significant >10 mmHg). Consequences include synthetic failure (hypoalbuminemia, coagulopathy), impaired detoxification (hyperammonemia → hepatic encephalopathy), and portal hypertension complications (varices, ascites, splenomegaly).