Hepatic Encephalopathy in Liver Transplant Candidates

Hepatic Encephalopathy is a potentially fatal complication of advanced liver disease. This condition is thought to occur when blood draining from the gut, containing toxic metabolites, is able to bypass the liver and affect the brain. In liver patients, large bypass channels may form which contribute to this pathophysiological shunting. Once formed, these channels decompress the high blood pressure in the veins, a key indicator of which is a reduction in the size of the spleen. We hypothesise that spleen size, easily measured by simple ultrasound, is inversely related to the risk of encephalopathy in liver disease. The project will assess spleen size and the relationship with intra-abdominal venous shunts and encephalopathy in patients with liver disease. The objective is to derive a risk score which will help non-specialists identify those patients at higher risk of encephalopathy before the development of this life-threatening complication