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Kapil Chopra, MD discusses complications of cirrhosis of the liver, clinical management and potential preventative approaches.

Educational objectives:

Upon completion of this activity, participants should be able to:

  • Increase patient outcomes in cirrhosis of the liver by recognizing the natural history of cirrhosis of the liver (i.e. compensated versus decompensated cirrhosis of the liver)
  • Improve diagnostic skills in early identification and treatment of infections in patients with cirrhosis of the liver admitted to the hospital.
  • ldentify the appropriate clinical situations in a patient with cirrhosis of the liver where use of prophylactic antiobiotics are indicated

Reading Resources:

  1. Jasmohan S Bajaj, Jacqueline G O'Leary, Florence Wong, K Rajender Reddy, Patrick S Kamath. Bacterial infections in end-stage liver disease: current challenges and future directions. Gut 2012;61:1219-1225. 
  2. Alexander R Bonne, Chalermat Bunchorntavakul, K Rajender Reddy. Immune Dysfunction and Infections in Patients With Cirrhosis. Clinical Gastroenterology and Hepatology 2011;9:727-738.
  3. Javier Fernandez, Vicente Arroyo. Bacterial Infections in Cirrhosis: A Growing Problem with Significant Implications. Clinical Liver Disease, Vol. 2, No. 3, June 2013.
  4. Guadalupe Garcia-Tsao. Bacterial infections in cirrhosis: treatment and prophylaxis. Journal of Hepatology 42 (2005) 585-592.
  5. 5ahar Ghassemi, Guadalupe Garcia-Tsao. Prevention and treatment of infections in patients with cirrhosis. Best Practice & Research Clinical Gastroenterology Vol. 21, No. 1, pp. 77e93, 2007.
  6. Javier Fernandez, Thierry Gustot. Management of bacterial infections in cirrhosis. Journal of Hepatology 2012;51-512.
  7. Rogelio Barreto, Claudia Fagundes, Monica Guevara, Elsa Soi,Gustavo Pereira, Ezequiel Rodnguez, Isabel Graupera, Marta Martm-Liah1, Xavier Ariza,Andres Cardenas,Javier Fernandez, Juan Rodes, Vicente Arroyo, Pere Gines. Type-1 Hepatorenal Syndrome Associated With Infections in Cirrhosis: Natural History, Outcome of Kidney Function, and Survival. Hepatology 2014; 59: 1505-1513.
  8. Ezequiel Rodriguez, Chiara Elia, Elsa Sola, Rogelio Barreto, Isabel Graupera, Alida Andrealli, Gustavo Pereira, Maria Poca, Jordi Sanchez, Monica Guevara, German Soriano, Carlo Alessandria, Javier Fernandez, Vicente Arroyo, Pere Gines. Terlipressin and albumin for type-1 hepatorenal syndrome associated with sepsis. Journal of Hepatology 2014 vol. 60; 955-961.
  9. Claire Francoz, Francois Durand. Type-1 hepatorenal syndrome in patients with cirrhosis and infection vs. sepsis-induced acute kidney injury: What matters? Journal of Hepatology 2014 vol. 60;907-909.
  10. Bruce A. Runyon. AASLD Practice Guideline. Management of Adult Patients with Ascites Due to Cirrhosis: Update 2012 . Hepatology February 2013.


Dr. Chopra has no relevant relationships with any entities producing health care goods or services.

All presenters disclosure of relevant financial relationships with any any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above.  No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.1) continuing education units (CEU) which are equivalent to 1.0 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 2/16/2015 | Last Modified On: 4/25/2016 | Expires: 4/25/2017

This course has been expired.