Lymphatic dysfunction in advanced cirrhosis:Contextual perspective and clinical implications

作     者：Ramesh Kumar Utpal Anand Rajeev Nayan Priyadarshi 

作者机构：Department of GastroenterologyAll India Institute of Medical SciencesPatna 801507BiharIndia Department of Surgical GastroenterologyAll India Institute of Medical SciencesPatna 801507BiharIndia Department of RadiodiagnosisAll India Institute of Medical SciencesPatna 801507BiharIndia 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第3期

页      面：300-314页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Lymphatic dysfunction Cirrhosis Lymphedema Lymphangiectasia Chylous ascites Refractory ascites 

摘      要：The lymphatic system plays a very important role in body fluid homeostasis,adaptive immunity,and the transportation of lipid and waste *** patients with liver cirrhosis,capillary filtration markedly increases,primarily due to a rise in hydrostatic pressure,leading to enhanced production of ***,lymphatic vasculature expansion helps to prevent fluid from accumulating by returning it back to the systemic ***,the lymphatic functions become compromised with the progression of cirrhosis and,consequently,the lymphatic compensatory mechanism gets overwhelmed,contributing to the development and eventual worsening of ascites and *** changes,low-grade chronic inflammation,and compounding effects of predisposing factors such as old age,obesity,and metabolic syndrome appear to play a significant role in the lymphatic dysfunction of *** portal hypertension can contribute to the development of intestinal lymphangiectasia,which may rupture into the intestinal lumen,resulting in the loss of protein,chylomicrons,and lymphocyte,with many clinical ***,due to high pressure,the rupture of the subserosal lymphatics into the abdomen results in the formation of chylous *** being highly significant,lymphatic dysfunctions in cirrhosis have largely been ignored;its mechanistic pathogenesis and clinical implications have not been studied in *** recommendation exists for the diagnostic evaluation and therapeutic strategies,with respect to lymphatic dysfunction in patients with *** article discusses the perspectives and clinical implications,and provides insights into the management strategies for lymphatic dysfunction in patients with cirrhosis.