2012-9-27 BIOCHEMISTRY OF LIVER FUNCTION Metavir Scoring System for Fibrosis Centrel vi F3 F4 Scoring Systems for fibrosis Progression Histological“母“ F4(Cirrhosis) Non-cirmhotk Compensated Compensated Decompensated None(no varices) None varices G, magI Biological Fibrogenesis Scar and Thick (acelluar ngiogenesis X-linking Stage Pathophysiology Portal Hvpertension -Pathogenesis Pressure Flow x Resistance estruction of hepatocytes ncreased flow Flbrockyecarming (Splanchnic Vasculature) ncreased pressure in the venous and sinusoidal channel Modulable function injury contraction2012-9-27 6 Metavir Scoring System for Fibrosis F1 F3 F2 F4 Modified from Poynard Scoring Systems for fibrosis Progression METAVIR Knodell Ishak F4 F4 F6 F3-F4 F3-F4 F5 F3 F3 F4 F2 F1-F3 F2-F3 F1 F1 F2 F0-F1 F0-F1 F1 F0 F0 F0 Friedman SL. Gastroenterology, 2008 Classification of chronic liver disease based on hisptological, clinical, hemodynamic, and biological parameters. Pathophysiology Etiology Alcohol abuse, Malnutrition, infection, drugs, Fatty infiltration, biliary obstruction… Portal hypertension Destruction of hepatocytes Fibrosis/scarring Liver function Injury Obstruction of blood flow Increased pressure in the venous and sinusoidal channel