End-stage liver disease is also called chronic liver failure.
“Most often, chronic liver failure is the result of cirrhosis, a condition in which scar tissue replaces healthy liver tissue until the liver cannot function adequately. Patients with abnormal liver function who develop ascites, variceal hemorrhage, hepatic encephalopathy, or renal impairment are considered to have end-stage liver disease (ESLD).” USCF
SBP.
MELD-Score
Why Vit K works for patients for reversing INR in patients on Coumadin but doesn’t do much for patients with ESLD?
Coumadin works by inhibiting the synthesis of vitamin K-dependent coagulation factors (II, VII, IX, X, Proteins C and S). Giving Vitamin K in a patient with a high INR from coumadin works by increasing the synthesis of the factors.
In Cirrhosis, the liver is destroyed and so can’t respond to Vitamin K and so the effect is minimal.
Check out this UTD topic
Management of Coagulopathy in Liver Disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076882/
Complications of end-stage liver disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721840/
http://www.bloodjournal.org/content/128/22/2583?sso-checked=true
https://www.uptodate.com/contents/cirrhosis-in-adults-overview-of-complications-general-management-and-prognosis/print
https://transplant.surgery.ucsf.edu/conditions–procedures/end-stage-liver-disease-(esld).aspx
https://transplant.surgery.ucsf.edu/conditions–procedures/end-stage-liver-disease-(esld).aspx
https://patient.info/doctor/cirrhosis-pro